Impact of type 1 diabetes and glycemic control on fetal aneuploidy biochemical markers

Helen Nordahl Madsen, Charlotte Ekelund, Niels Tørring, Per Ovesen, Lennart Friis-Hansen, Lene Ringholm Nielsen, Olav Petersen

Research output: Contribution to journalJournal articleResearchpeer-review


OBJECTIVE:  To determine the influence of type 1 diabetes mellitus (T1DM) on the first trimester serum markers of fetal aneuploidy; pregnancy-associated plasmaprotein-A (PAPP-A) and free beta subunit of human chorionic gonadotropin (freeβ-hCG) and to evaluate the influence of glycemic control on these parameters in the pregnant diabetic women.  DESIGN:  Retrospective study.  SETTING:  Data were extracted from electronic obstetric and laboratorydatabases at two Danish University Hospitals.  POPULATION:  Based on 36 415 pregnancies without T1DM (non-T1DM) and 331 pregnancies with T1DM; β-hCG and PAPP-A were obtained at 8+0 to 14+2 gestational weeks.  METHODS:  Medians for PAPP-A and free β-hCG were generated and multiple of the normal gestation-specific median (MoM) values were calculated for each separate pregnancy. After adjustment for maternal weight, ethnicity and smoking status, MoM values were compared across the T1DM and non-T1DM groups, respectively. Additionally, the relationship between PAPP-A MoM and HgbA1C was examined in 348 T1DM pregnancies by Spearman's rank correlation. MAIN OUTCOME MEASURES. Difference in biochemical marker levels between T1DM and non-T1DM.  RESULTS:  PAPP-A was 0.86 MoM in T1DM pregnancies and 1.01 MoM in non-T1DM pregnancies, p < 0.0001. Conversely, free β-hCG was not altered in T1DM pregnancies (T1DM 0.99 MoM, non-T1DM 0.98 MoM; p=0.14). There was a significant inverse correlation between HgbA1C and PAPP-A (rho=-0.12, p=0.02).  CONCLUSIONS:  In T1DM pregnancies, PAPP-A MoM values were lower than in non-T1DM pregnancies. This suggests that correction should be considered in first trimester biochemical screening for fetal aneuploidy in T1DM women.
Original languageEnglish
JournalActa Obstetricia et Gynecologica Scandinavica
Issue number1
Pages (from-to)57-61
Publication statusPublished - 2012


  • disease, health science and nursing
  • fetal diseases


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