PAPP-A

This study examined the relationship and predictive value of first-trimester pregnancy-associated plasma protein A (PAPP-A), maternal factors, and biochemical markers in predicting gestational diabetes mellitus (GDM) among 4872 pregnant women in southern China. GDM was diagnosed in 15.39% of participants (750 women). Low PAPP-A levels were identified as an independent risk factor for GDM, along with age, pre-gestational BMI, gestational weight gain, previous GDM history, family history of diabetes, fasting plasma glucose (FPG), triglycerides (TG), low-density lipoproteins (LDL), and total cholesterol (TC). However, the predictive ability of PAPP-A alone was limited (AUC = 0.56, 95% CI: 0.53-0.58). When combined with maternal factors and biochemical markers, the model's predictive value improved significantly (AUC = 0.70, 95% CI: 0.68-0.72, P < 0.001). The study concludes that while low PAPP-A levels are an independent risk factor for GDM, their predictive value is enhanced when combined with other clinical and biochemical factors.