PAPP-A

Gestational diabetes mellitus (GDM) is a prevalent pregnancy complication and a leading cause of adverse maternal and fetal outcomes. Early diagnosis is crucial, yet current clinical guidelines recommend universal screening with a 75 g oral glucose tolerance test at 24–28 weeks of gestation, often leading to delayed detection and intervention. GDM is closely linked to insulin resistance and endothelial dysfunction, processes that are significantly influenced by placental-derived factors. Recent studies highlight the roles of placental growth factor (PlGF) and pregnancy-associated plasma protein-A (PAPP-A) in modulating insulin sensitivity and vascular function. PlGF is essential for placental vascularization, while PAPP-A facilitates the cleavage of insulin-like growth factor binding protein-4, impacting glucose metabolism. These biomarkers are already utilized for early detection of pregnancy complications such as preeclampsia and fetal aneuploidies, and emerging evidence suggests their potential utility in predicting GDM. However, inconsistencies across studies necessitate further research to validate their clinical applicability for early GDM screening.