Glycosylated fibronectin as a biomarker to predict gestational diabetes mellitus in the first trimester of pregnancy.

BACKGROUND

Gestational diabetes mellitus (GDM) increases the maternal and fetal risk, including macrosomia, shoulder dystocia or other birth injuries, premature delivery, and preeclampsia. Diagnosis of GDM in early pregnancy may help to prevent these complications. Our study aims to evaluate the usefulness of glycosylated fibronectin in the prediction of GDM in the first trimester of pregnancy and to compare its level in pregnant women with GDM and without GDM.

METHODS

After ethics approval and written informed consent, this prospective, single-centre, cohort study was done on 120 pregnant women. The sample for the analysis of serum glycosylated fibronectin was collected at 7-13 weeks of gestation and stored at -180 degrees for further analysis by the Western blot method. We used screening strategies as recommended by the International Association of Diabetes and Pregnancy Study Groups (IADPSG) for the detection of GDM by an oral glucose tolerance test (OGTT) after taking 75 grams of glucose at 24-28 weeks of gestation. Out of a total of 120 screened patients, 42 pregnant women by OGTT were diagnosed to have GDM grouped, as cases. A similar number of non-GDM pregnant patients were taken and considered as the control group. Both groups were analyzed for glycosylated fibronectin after getting the result of OGTT between 24-28 weeks of pregnancy.

RESULTS

There were decreased levels of first-trimester maternal serum glycosylated fibronectin in GDM than in non-GDM pregnant women with the area under the receiver operating characteristic (ROC) curve was 72.4% (95% CI: 61.6% to 83.2%. P value < 0.001).

CONCLUSION

We found decreased levels of first-trimester maternal serum glycosylated fibronectin in GDM than in non-GDM pregnant women. This study proves that the glycosylated fibronectin test is of modest diagnostic accuracy and clinical applicability as an early screening method for the prediction of GDM in the first trimester of pregnancy.