Early pregnancy prediction of gestational diabetes mellitus risk using prenatal screening biomarkers in nulliparous women
| Autor: | Laura L. Jelliffe-Pawlowski, Scott P. Oltman, Wei Bao, Brittney M. Snyder, Rebecca J. Baer, Knute D. Carter, Andrea L. Greiner, Jennifer G. Robinson, Audrey F. Saftlas, Larry Rand, Kelli K. Ryckman, Patrick Breheny |
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| Rok vydání: | 2020 |
| Předmět: |
Inhibin a
Endocrinology Diabetes and Metabolism Early pregnancy factor Reproductive health and childbirth Gestational diabetes mellitus Cohort Studies 0302 clinical medicine Endocrinology Pregnancy Prenatal Diagnosis Medicine Psychology 030212 general & internal medicine Pediatric education.field_of_study screening and diagnosis biology Obstetrics Diabetes General Medicine Gestational diabetes Detection Prenatal screening Gestational Public Health and Health Services Female Cohort study 4.2 Evaluation of markers and technologies Adult medicine.medical_specialty Population Clinical Sciences 030209 endocrinology & metabolism Article 03 medical and health sciences Endocrinology & Metabolism Prediction model Clinical Research Diabetes mellitus Internal Medicine Humans Conditions Affecting the Embryonic and Fetal Periods education Receiver operating characteristic business.industry Prevention Perinatal Period - Conditions Originating in Perinatal Period medicine.disease Clinical utility 4.1 Discovery and preclinical testing of markers and technologies Diabetes Gestational Risk management biology.protein business Biomarkers |
| Zdroj: | Diabetes Res Clin Pract |
| Popis: | Aims To evaluate the clinical utility of first and second trimester prenatal screening biomarkers for early pregnancy prediction of gestational diabetes mellitus (GDM) risk in nulliparous women. Methods We conducted a population-based cohort study of nulliparous women participating in the California Prenatal Screening Program from 2009 to 2011 (n = 105,379). GDM was ascertained from hospital discharge records or birth certificates. Models including maternal characteristics and prenatal screening biomarkers were developed and validated. Risk stratification and reclassification were performed to assess clinical utility of the biomarkers. Results Decreased levels of first trimester pregnancy-associated plasma protein A (PAPP-A) and increased levels of second trimester unconjugated estriol (uE3) and dimeric inhibin A (INH) were associated with GDM. The addition of PAPP-A only and PAPP-A, uE3, and INH to maternal characteristics resulted in small, yet significant, increases in area under the receiver operating characteristic curve (AUC) (maternal characteristics only: AUC 0.714 (95% CI 0.703–0.724), maternal characteristics + PAPP-A: AUC 0.718 (95% CI 0.707–0.728), maternal characteristics + PAPP-A, uE3, and INH: AUC 0.722 (0.712–0.733)); however, no net improvement in classification was observed. Conclusions PAPP-A, uE3, and INH have limited clinical utility for prediction of GDM risk in nulliparous women. Utility of other readily accessible clinical biomarkers in predicting GDM risk warrants further investigation. |
| Databáze: | OpenAIRE |
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