First Trimester Potential Biochemical Predictive Tests for Gestational Diabetes Mellitus: A Systematic Review

  • Soodabeh Darvish Assistant Professor of Obstetrics Gynecology, Fellowship of Female Pelvic Medicine and Reconstructive Surgery, Taleghani Hospital, Department of Obstetrics Gynecology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • Farzaneh Rashidi Fakari PhD, Assistant Professor, Department of Midwifery, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran.
  • Simin Haghdoost Department of Midwifery, Urmia Branch, Islamic Azad University, Urmia, Iran.
Keywords: Gestational diabetes, First trimester, Biomarker, Review


Objective: Gestational diabetes mellitus (GDM) is the most common metabolic complication during pregnancy. So, a large number of studies have evaluated the usefulness of different screening tests. The aim of this study was focused on the potential of only first-trimester screening used in the prediction of GDM.

Materials and Methods: In this systematic review, we searched PubMed, EMBASE, and Scopus (between 2010 and 2020) and also searched the reference lists of the relevant articles manually. After performing a thorough evaluation of the 242 potentially eligible papers, only 60 papers were selected in terms of the inclusion criteria. Search key terms were combining ‘Gestational diabetes’ or ‘GD’ “gestational diabetes mellitus” or” GDM” or pregnancy-induced diabetes’ with at least one of the following terms: “screening test”, “first-trimester”, “prediction”, “marker predictor”, “serum marker”.

Results: A total of 161954 pregnant women were evaluated in these reviewed studies. Moreover, many tests were assessed in the first trimester of pregnancy to predict GDM. This review showed that hs-CRP, FPG, TG, and LDL-C along with maternal BMI in the first trimester were related to the increased risk of developing GDM. Other tests were used in only one or two studies.

Conclusion: This review showed that hs-CRP, FPG, TG, and LDL-C along with maternal BMI in the first trimester were linked to an increased risk of developing GDM. It is recommended that further well-designed studies by considering the cost-effective advantages of these predictive tests, should be performed.