The Relationship Between Glycosylated Hemoglobin And PAPP-A In Early Pregnancy And Gestational Diabetes

Objective:Analyze the relationship between PAPP-A and glycosylated hemoglobin in early pregnancy and gestational diabetes（GDM）,and provide a new basis for early diagnosis of GDM..Method:From December 2018 to July 2019,from 11-13⁺⁶weeks of pregnancy,1,000 pregnant women who have undergone premature pregnancy check-ups in th-e outpatient clinic of Anhui Province Maternal and Child Health Hospital were selected for clinical data collection and early pregnancy fasting blood glucose（F-PG）and pregnancy-related plasma were recorded.For protein-A median multiples（PAPP-A Mo M）and glycosylated hemoglobin（HbA1c）,oral glucose tolerance te-st（OGTT）was performed at 24-28 weeks.In the end,958 cases were followed up,of which 90 cases of GDM were designated as the study group,and 868cases with normal OGTT were designated as the control group.All subjects were followed up to the pregnancy outcome.Analyze the best cut-off value of early pregnancy serological indicators for predicting G-DM and get the most suitable combined prediction plan.SPSS 23.0 was used fo-r statistical analysis,and P<0.05 indicated that the difference was statistically sig-nificant.Result:1.The two groups of study subjects have no history of smoking;the study group has a family history of diabetes,pregnancy times≥3 times,and the proport-ion of those who use assisted reproductive technology is higher than that ofthec-ontrol group（all P<0.05）,but in the education level,age and childbirth In the second aspect,thedifference was not statistically significant（all P>0.05）;BMI,FPG and HbA1c were higher in the study group（all P<0.001）,while PAPP-A mom was lower（P<0.05）;2.High levels of FPG,high levels of HbA1c,low levels of PAPP-A,pregnancy with assisted reproductive technology,family history of diabetes,and BMI of low or overweight are all independent risk factors for GDM;3.The cut-off point corresponding to the largest Youden index of FPG is 4.735mmol/L,and the AUC is 0.674,which is of low diagnostic value for GDM;the best cut-off value for HbA1c is 5.35%,and the AUC is 0.707,which has certai-n diagnostic significance for GDM;The best cut-off value of PAPP-A Mo M is0.24,and the AUC is only 0.380,which is of no diagnostic significance;4.The AUC of PAPP-A Mo M+HbA1c is 0.721,which has certain diagnostic sig-nificance for GDM;PAPP-A Mo M+FPG AUC is 0.672,which has a low diagn-ostic value for GDM;the AUC of FPG+HbA1c is 0.717,which has a certain C-ertain diagnostic significance;the AUC of PAPP-A Mo M+FPG+HbA1c is 0.728which has certain diagnostic significance for GDM;5.HbA1c was negatively correlated with PAPP-A in the study group（P<0.05）;6.Compared with the study group,the PAPP-A level of the adverse pregnancy group was lower,and the difference was significant（P<0.05）;7.The incidence of hypertension in pregnancy,acute chorioamnionitis,postpartum hemorrhage,premature delivery,premature rupture of membranes,fetal distress,and macrosomia was higher in the study group,and the difference between the two groups was significant（all P<0.05）.Conclusion:The combined detection of HbA1c and PAPP-A MOM in early preg nancy has great clinical significance in the prediction of GDM.