Predictive Value of Four Indicators Included in Maternal Serum Down Syndrome Screening for Gestational Diabetes Mellitus

• Main Authors: Hui-Chuan Shen, 沈惠娟
• Other Authors: Sheng-Hsian Chen
• Format: Others
• Language: zh-TW
• Online Access: http://ndltd.ncl.edu.tw/handle/28163437590733170478

碩士 === 南台科技大學 === 生物科技系 === 101 === Gestational diabetes mellitus(GDM) is a common complication that may occur during pregnancy. Continuously rising and poorly controlled hyperglycemia can endanger both mother and fetus because of adverse pregnancy outcome. Previous studies have shown that GDM is strongly correlated to insulin resistance that is induced by hormone secretions, particularly pregnancy-associated hormones relevant to the fetal-placental unit (FPU). However, GDM cannot be diagnosed until 24-28 weeks of gestation because specific markers are unavailable for predicting the development of GDM during the first trimester. This study used Down’s syndrome screening that are during the second trimester using quadruple test (ie, AFP, total hCG, uE3, and inhibin-A) to facilitate the early prediction of GDM. The research participants were randomly selected from 4293 pregnant women who received prenatal examinations in Chi-Mei Medical Center between August 2009 and July 2012. In this study, 117 healthy pregnant women were included into the control group; 110 participants were within all normal glucose range on the oral glucose tolerance test (OGTT); 38 women received one abnormal result on the OGTT; and 60 were confirmed to have GDM. This study explores the correlation of the quad markers to varying glucose intolerance levels and the development of GDM. GDM was confirmed based on the diagnostic criteria for the 100-g OGTT established by the American Diabetes Association (ADA, 2009). The statistical results showed that the prevalence of GDM was 4.05%. The group with GDM all demonstrated heavier weights and older ages compared to other groups (weight: P = 0.000; age: P =0 .036). Pregnant women at high risk of Down’s syndrome had a higher GDM incidence rate compared to healthy pregnant women (5.9%:2.4%；p=0.005). Only uE3 among the quad markers presented statistically significant differences (uE3: 0.93 MoM, 95% CI: 0.87-0.99; control: 1.02 MoM, 95% CI: 0.97-1.0; P =0 .022). The area under the receiver operating characteristic (ROC) curve was 0.612 (P =0.015). The results indicated that pregnant women at high risk for Down’s syndrome tended to have a higher incidence rate of GDM compared to pregnant women with normal risks. In the second trimester screening for Down’s syndrome using the quad markers, uE3 in a low concentration can to prediction the development of GDM.