ArticleBMC pregnancy and childbirth2024
First trimester maternal serum PAPP-A and free β-hCG levels and risk of SGA or LGA in women with and without GDM.
Article in BMC pregnancy and childbirth, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Diagnostic performance of PAPP-A and β-hCG in early detection of gestational diabetes mellitus: a meta-analysis.Acta diabetologica · 2026Pooled it
- Integrated First-Trimester Assessment of Placental Biomarkers, Metabolic Indices, and IGF-1/IGFBP-5 in Relation to Subsequent Gestational Diabetes Mellitus: A Prospective Cohort Study.Medicina (Kaunas, Lithuania) · 2026Article
- Assessment of Fetal Cardiac Function and Pregnancy Outcomes in Well-Controlled Gestational Diabetes Mellitus Using Novel Ultrasound Technology: A Prospective Case-Control Study.Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine · 2026Article
- Sex-Specific Variation in Maternal Serum Screening Markers Across the First and Second Trimesters: Evidence from 10,384 Screened Pregnancies.Journal of clinical medicine · 2026Article
- Emerging biomarkers for gestational diabetes mellitus and related pediatric outcomes.World journal of clinical pediatrics · 2025Review
- First-trimester biomarkers of gestational diabetes mellitus: A scoping review.Acta obstetricia et gynecologica Scandinavica · 2025Article
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5 authors.
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Abstract
backgroundMaternal gestational diabetes (GDM), small (SGA) and large (LGA) for gestational age neonates are associated with increased morbidity in both mother and child. We studied how different levels of first trimester pregnancy associated plasma protein-A (PAPP-A) and free beta human chorionic gonadotropin (fβ-hCG) were associated with SGA and LGA in GDM pregnancies and controls.
methodsAltogether 23 482 women with singleton pregnancies participated in first trimester combined screening and delivered between 2014 and 2018 in Northern Finland and were included in this retrospective case-control study. Women with GDM (n = 4697) and controls without GDM (n = 18 492) were divided into groups below 5th and 10th or above 90th and 95th percentile (pc) PAPP-A and fβ-hCG MoM levels. SGA was defined as a birthweight more than two standard deviations (SD) below and LGA more than two SDs above the sex-specific and gestational age-specific reference mean. Odds ratios were adjusted (aOR) for maternal age, BMI, ethnicity, IVF/ICSI, parity and smoking.
resultsIn pregnancies with GDM the proportion of SGA was 2.6% and LGA 4.5%, compared to 3.3% (p = 0.011) and 1.8% (p < 0.001) in the control group, respectively. In ≤ 5th and ≤ 10th pc PAPP-A groups, aORs for SGA were 2.7 (95% CI 1.5-4.7) and 2.2 (95% CI 1.4-3.5) in the GDM group and 3.8 (95% CI 3.0-4.9) and 2.8 (95% CI 2.3-3.5) in the reference group, respectively. When considering LGA, there was no difference in aORs in any high PAPP-A groups. In the low ≤ 5 percentile fβ-hCG MoM group, aORs for SGA was 2.3 (95% CI 1.8-3.1) in the control group. In fβ-hCG groups with GDM there was no association with SGA and the only significant difference was ≥ 90 percentile group, aOR 1.6 (95% CI 1.1-2.5) for LGA.
conclusionAssociation with low PAPP-A and SGA seems to be present despite GDM status. High PAPP-A levels are not associated with increased LGA risk in women with or without GDM. Low fβ-hCG levels are associated with SGA only in non-GDM pregnancies.
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