First Trimester Aneuploidy Screening Markers in Women with Pre-Gestational Diabetes MellitusReport as inadecuate




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1

Department of Obstetrics and Gynecology, University of Connecticut Health Center-School of Medicine, Farmington, CT 06032, USA

2

Department of Genetics and Developmental Biology, University of Connecticut Health Center-School of Medicine, Farmington, CT 06032, USA

3

Biostatistics Center, Connecticut Institute for Clinical and Translational Science, University of Connecticut Health Center-School of Medicine, Farmington, CT 06032, USA





*

Author to whom correspondence should be addressed.



Abstract Objective: To investigate whether maternal serum pregnancy associated plasma protein-A PAPP-A, total β human chorionic gonadotropin hCG levels and nuchal translucency NT measurements differ in women with pre-gestational diabetes mellitus PGDM compared to non-diabetic controls and to assess whether correction factors are needed for diabetic women in calculation of aneuploidy risks. Study Design: We performed a retrospective study of all women who underwent first trimester aneuploidy screening 11 + 0 to 13 + 6 weeks from 2005 to 2011. The primary study outcome was the difference in PAPP-A, β-hCG and NT multiples of median between women with PGDM and non-diabetic women. Results: Of 6741 eligible patients, 103 patients with PGDM were using insulin and 4 patients were using oral hypoglycemic agents; the latter were excluded due to small number. There was 12% reduction of median PAPP-A p = 0.001 and 18% reduction of median hCG p = 0.006 in women with PGDM receiving insulin. There was no difference in NT. Conclusions: In women with PGDM receiving insulin, PAPP-A and β-hCG levels are significantly lower compared to non-diabetic women. This suggests that when calculating risks for aneuploidy, correction factors should be considered to adjust PAPP-A and β-hCG concentrations to those seen in non-diabetic women. View Full-Text

Keywords: re-gestational diabetes; aneuploidy; first trimester screening; PAPP-A; β-hCG; correction factors; HbA1c re-gestational diabetes; aneuploidy; first trimester screening; PAPP-A; β-hCG; correction factors; HbA1c





Author: Padmalatha Gurram 1,* , Peter Benn 2, James Grady 3, Anne-Marie Prabulos 1 and Winston Campbell 1

Source: http://mdpi.com/



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