First Trimester Combined Test (FTCT) as a Predictor of Gestational Diabetes Mellitus

Federica Visconti, Paola Quaresima, Eusebio Chiefari, Patrizia Caroleo, Biagio Arcidiacono, Luigi Puccio, Maria Mirabelli, Daniela P. Foti, Costantino Di Carlo, Raffaella Vero and Antonio Brunetti
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Federica Visconti: Unit of Obstetrics and Gynecology, Department of Medical and Surgical Sciences, University “Magna Græcia” of Catanzaro, Viale Europa, 88100 Catanzaro, Italy
Paola Quaresima: Unit of Obstetrics and Gynecology, Department of Medical and Surgical Sciences, University “Magna Græcia” of Catanzaro, Viale Europa, 88100 Catanzaro, Italy
Eusebio Chiefari: Department of Health Sciences, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, Italy
Patrizia Caroleo: Complex Operative Structure Endocrinology-Diabetology, Hospital Pugliese-Ciaccio, 88100 Catanzaro, Italy
Biagio Arcidiacono: Department of Health Sciences, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, Italy
Luigi Puccio: Complex Operative Structure Endocrinology-Diabetology, Hospital Pugliese-Ciaccio, 88100 Catanzaro, Italy
Maria Mirabelli: Department of Health Sciences, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, Italy
Daniela P. Foti: Department of Health Sciences, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, Italy
Costantino Di Carlo: Unit of Obstetrics and Gynecology, Department of Medical and Surgical Sciences, University “Magna Græcia” of Catanzaro, Viale Europa, 88100 Catanzaro, Italy
Raffaella Vero: Complex Operative Structure Endocrinology-Diabetology, Hospital Pugliese-Ciaccio, 88100 Catanzaro, Italy
Antonio Brunetti: Department of Health Sciences, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, Italy

IJERPH, 2019, vol. 16, issue 19, 1-10

Abstract: Background —The first trimester combined test (FTCT) is an effective screening tool to estimate the risk of fetal aneuploidy. It is obtained by the combination of maternal age, ultrasound fetal nuchal translucency (NT) measurement, and the maternal serum markers free β-human chorionic gonadotropin (β-hCG) and pregnancy-associated plasma protein A (PAPP-A). However, conflicting data have been reported about the association of FTCT, β-hCG, or PAPP-A with the subsequent diagnosis of gestational diabetes mellitus (GDM). Research design and methods —2410 consecutive singleton pregnant women were retrospectively enrolled in Calabria, Southern Italy. All participants underwent examinations for FTCT at 11–13 weeks (plus 6 days) of gestation, and screening for GDM at 16–18 and/or 24–28 weeks of gestation, in accordance with current Italian guidelines and the International Association Diabetes Pregnancy Study Groups (IADPSG) glycemic cut-offs. Data were examined by univariate and logistic regression analyses. Results —1814 (75.3%) pregnant women were normal glucose tolerant, while 596 (24.7%) were diagnosed with GDM. Spearman univariate analysis demonstrated a correlation between FTCT values and subsequent GDM diagnosis ( ρ = 0.048, p = 0.018). The logistic regression analysis showed that women with a FTCT <1:10000 had a major GDM risk ( p = 0.016), similar to women with a PAPP-A <1 multiple of the expected normal median (MoM, p = 0.014). Conversely, women with β-hCG ≥2.0 MoM had a reduced risk of GDM ( p = 0.014). Conclusions —Our findings indicate that GDM susceptibility increases with fetal aneuploidy risk, and that FTCT and its related maternal serum parameters can be used as early predictors of GDM.

Keywords: ?-human chorionic gonadotropin; fetal nuchal translucency; first trimester combined test; gestational diabetes mellitus; pregnancy-associated plasma protein A (PAPP-A) (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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