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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

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Received: 21 February 2014; in revised form: 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 which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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MDPI and ACS Style

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.

AMA Style

Gurram P, Benn P, Grady J, Prabulos A-M, Campbell W. First Trimester Aneuploidy Screening Markers in Women with Pre-Gestational Diabetes Mellitus. Journal of Clinical Medicine. 2014; 3(2):480-490.

Chicago/Turabian Style

Gurram, Padmalatha; Benn, Peter; Grady, James; Prabulos, Anne-Marie; Campbell, Winston. 2014. "First Trimester Aneuploidy Screening Markers in Women with Pre-Gestational Diabetes Mellitus." J. Clin. Med. 3, no. 2: 480-490.


J. Clin. Med. EISSN 2077-0383 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert