Evidence map›Paper›PMID 40474757›Full record

SynthesisAmerican journal of reproductive immunology (New York, N.Y. : 1989)2025

Prognostic Impact of Pregnancy-Associated Plasma Protein-A (PAPP-A) for Gestational Diabetes Mellitus (GDM): An Updated Systematic Review and Meta-Analysis of More Than 90 000 Pregnancies.

Ing-Luen Shyu, Yung-Chieh Tsai, Tian-Ni Kuo, Yow-Ling Shiue

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in American journal of reproductive immunology (New York, N.Y. : 1989), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Ing-Luen ShyuDepartment of Obstetrics and Gynecology, Chi Mei Medical Center, Tainan, Taiwan.ORCID 0009-0001-7371-0594
Yung-Chieh TsaiDepartment of Obstetrics and Gynecology, Chi Mei Medical Center, Tainan, Taiwan.
Tian-Ni KuoDepartment of Obstetrics and Gynecology, Chi Mei Medical Center, Tainan, Taiwan.
Yow-Ling ShiueInstitute of Biomedical Sciences, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveGestational diabetes mellitus (GDM) constitutes a significant health concern during pregnancy, warranting a thorough investigation into potential prognostic markers. Pregnancy-associated plasma protein-A (PAPP-A), which is present at high levels during pregnancy, exhibits altered concentrations even before the clinical diagnosis of GDM, highlighting its potential as an early biomarker for this condition. This systematic review and meta-analysis aimed to review and synthesize the latest evidence comprehensively to explore the correlation between maternal PAPP-A levels and the development of GDM, drawing from the most recent publications available.

methodsPubMed, EMBASE, and Cochrane CENTRAL were searched systematically up to June 2, 2024. Cohort and case-control studies reporting PAPP-A levels in GDM and non-GDM women with singleton pregnancy were eligible for inclusion. The quality of studies was measured using the Newcastle-Ottawa scale (NOS). Standardized mean differences (SMDs) of PAPP-A levels between GDM and non-GDM, and odds ratios (ORs) of the association between PAPP-A and GDM were pooled, with heterogeneity assessed using the Cochran Q test and I

resultsNineteen studies involving 92 200 pregnant women were included in the systematic review and meta-analysis. The gestational age at sampling varied from 10 to 14 weeks. Meta-analysis revealed a significantly lower PAPP-A level among women with GDM compared with those without (pooled SMD = -0.31, 95% CI: -0.56 to -0.06). Furthermore, meta-analysis revealed that women with a low PAPP-A level had a significantly higher risk of developing GDM (pooled OR = 1.75, 95% CI: 1.45-2.11). Despite observed publication bias, sensitivity analysis affirmed the robustness of the results.

conclusionsThis updated systematic review and meta-analysis underscored the prognostic significance of maternal PAPP-A levels with respect to the development of GDM. Low PAPP-A level is associated with an increased risk of GDM. These findings advocate for the inclusion of PAPP-A assessment in the clinical evaluation of GDM risk.

Indexed as

Diabetes, GestationalPregnancy-Associated Plasma Protein-ABiomarkersFemaleHumansPregnancyPrognosisBiomarkersPAPPA protein, humanPregnancy-Associated Plasma Protein-Agestational diabetes mellitus (GDM)predictionpregnancy‐associated plasma protein‐A (PAPP‐A)prognosis

Identifiers

PMID40474757
PMCPMC12142282

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.