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Aims/Introduction  To investigate the relationship between pregnancy‐associated plasma protein A ( PAPP ‐A) and gestational diabetes mellitus ( GDM ), and to determine whether  PAPP ‐A has improved value for predicting  GDM  in a Chinese population.    Materials and Methods  Clinical data for 599  GDM  patients and 986 unaffected pregnant women undergoing both antenatal examinations and delivery were retrospectively analyzed. First‐trimester serum  PAPP ‐A levels were compared between the groups. Binary logistic regression analysis was used to explore the risk factors for  GDM , and the area under the receiver operating characteristic curve was used to determine the value of  PAPP ‐A for predicting  GDM .    Results   GDM ‐affected and unaffected pregnant women were significantly different in terms of age ( P  < 0.001),  BMI  ( P  < 0.001), family history of diabetes ( P  = 0.002), α‐thalassemia trait ( P  < 0.01), parity ( P  < 0.001), conception methods ( P  < 0.001), gestational weeks at the time of labor ( P  < 0.001) and corrected  PAPP ‐A multiples of the median values ( P  < 0.001). Binary logistic regression analysis showed that  PAPP ‐A levels were negatively related to the subsequent development of  GDM  (odds ratio 0.798, 95% confidence interval 0.647–0.984). The area under the receiver operating characteristic curve for maternal factors was 0.684 (95% CI: 0.657–0.711), and did not significantly differ from that for the combination of maternal factors and serum  PAPP ‐A levels, which was 0.686 (95% CI: 0.660–0.713; χ 2  = 0.625,  P  = 0.429).    Conclusions  Serum  PAPP ‐A was an independent factor for the development of  GDM  in pregnant Chinese women. Serum‐ PAPP ‐A does not have improved value with respect to predicting  GDM  when combined with other maternal factors.

Gestational diabetes mellitus and first trimester pregnancy‐associated plasma protein A: A case–control study in a Chinese population