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J. Clin. Med. 2014, 3(2), 480-490; doi:10.3390/jcm3020480
Article

First Trimester Aneuploidy Screening Markers in Women with Pre-Gestational Diabetes Mellitus

1,* , 2
,
3
,
1
 and
1
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.
Received: 21 February 2014 / Revised: 18 March 2014 / Accepted: 19 March 2014 / Published: 8 May 2014
(This article belongs to the Special Issue Prenatal Genetic Screening and Diagnosis-Part 2)
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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.
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
This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).
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Gurram, P.; Benn, P.; Grady, J.; Prabulos, A.-M.; Campbell, W. First Trimester Aneuploidy Screening Markers in Women with Pre-Gestational Diabetes Mellitus. J. Clin. Med. 2014, 3, 480-490.

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