PAPP-A

This study investigated the associations between first-trimester biomarkers and maternal characteristics in predicting gestational diabetes mellitus (GDM) in a cohort of 1452 Chinese pregnant women, of whom 96 developed GDM. The levels of pregnancy-associated plasma protein A (PAPP-A) and placental growth factor (PLGF) were significantly lower in the GDM group compared to the non-GDM group (PAPP-A: 5.01 vs. 5.73 IU/L, P < 0.001; PLGF: 39.88 vs. 41.81 pg/mL, P = 0.044). A predictive model incorporating maternal characteristics and biomarkers demonstrated good discriminatory ability, with an area under the ROC curve of 0.73 (95% CI: 0.68–0.79, P < 0.001). Logistic regression revealed that higher pregestational BMI, previous GDM history, family history of diabetes, higher mean arterial pressure, and lower PAPP-A levels were independently associated with GDM. The Hosmer-Lemeshow test confirmed excellent model fit (P = 0.929). The study concludes that combining first-trimester biomarkers with maternal characteristics could enhance early risk prediction and aid in identifying women at high risk of developing GDM.