Correlation and diagnostic value of maternal serum alpha-fetoprotein level, predelivery age and body mass with gestational diabetes mellitus

Abstract

To investigate the correlation and diagnostic value of maternal serum alpha-fetoprotein (MSAFP) level, predelivery age and body mass with gestational diabetes mellitus (GDM) at 9 ∼ 13 + 6 weeks (early pregnancy) and 15 ∼ 20 + 6 weeks (middle pregnancy). 486 normal and 1290 GDM women were examined for serum pregnancy-associated plasma protein A (PAPP-A), MSAFP, free β-subunit of human chorionic gonadotropin (free β-hCG) and nuchal transparency (NT) levels. Binary logistic regression analysis was used to analyze the risk factors and calculate the Odds ratio (OR) of each relevant variable. In GDM group, the predelivery age, body mass in early pregnancy and middle pregnancy were statistically higher than that in control group. The level of MSAFP in GDM group was 0.97(0.54–1.86) MOM, higher than that in control group 0.92 (0.51–1.78), (z = 3.159, p = .002). Area under curve (AUC) of MSAFP, age and body mass to GDM was 0.549, 0.645 and 0.625, respectively. The level of MSAFP, predelivery age and body mass are associated with GDM, which may be helpful for the prediction of GDM in late pregnant women. However, PAPP-A, NT and free β-hCG during pregnancy have no predicting value for GDM.

摘要

目的是探讨妊娠9∼13 + 6周（妊娠早期）和15∼20 + 6周（妊娠中期）孕妇血清甲胎蛋白（MSAFP）水平、早产年龄和体重与妊娠期糖尿病（GDM）的相关性及诊断价值。研究纳入486例健康女性和1290例GDM女性, 检测其血清妊娠相关血浆蛋白A（PAPP-A）、MSAFP、人绒毛膜促性腺激素游离β亚基（游离β-hCG）和颈部透明层（NT）水平。采用二元logistic回归分析进行危险因素分析, 计算各相关变量的优势比（OR）。GDM组的早产年龄、妊娠早、中期妊娠体重均高于对照组, 差异有统计学意义。GDM组MASFP水平为0.97(0.54–1.86) MOM, 高于对照组0.92 (0.51–1.78), (z= 3.159, p = .002)。MSAFP曲线下面积（AUC）、年龄和体重对GDM的影响分别为0.549, 0.645和0.625。MSAFP水平、早产年龄和体重与GDM相关, 可能有助于预测晚期妊娠女性GDM的发生。而妊娠期PAPP-A, NT和游离 β-hCG对GDM无预测价值。

Keywords:

• Early pregnancy
• pregnancy-related plasma protein A
• alpha-fetoprotein
• free human chorionic gonadotropin β subunit
• prenatal screening
• gestational diabetes mellitus

Acknowledgements

The authors thank teacher Zhang Ping from the medical record room of Hangzhou Yuhang district Maternal and Child Health Hospital for data collection. The authors also give many thanks to the help provided by Lu Xiao and Shi ye Zhen from the Data Department of Zhejiang Bosheng Biotechnology co., Ltd in data matching and statistical processing.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The authors thank Zhejiang Public Welfare Technology Research Program/Social Development [LGF19H040006]; Zhejiang Medical and Health Research Project [discipline platform-2018ZD036]; Hangzhou Science and Technology Plan Leading Project/Agriculture and Social Development [20181228Y13]; Scientific Research Project of Hangzhou Yuhang District Science and Technology Bureau [Medical and Health-2018008] for funding the study.