Conventional gestational diabetes screening, typically performed in the late second trimester, often misses opportunities for early risk identification. A meta-analysis published in Acta Diabetologica suggests that first-trimester maternal serum biomarkers, pregnancy-associated plasma protein-A (PAPP-A) and beta-human chorionic gonadotropin (β-hCG), may provide moderate predictive value for early detection.

The analysis pooled data from 23 observational studies assessing first-trimester biomarker levels and their correlation with subsequent GDM diagnosis. The combined model demonstrated a pooled sensitivity of 63% and specificity of 70%, with an area under the curve (AUC) of 0.72. PAPP-A alone achieved moderate accuracy (sensitivity 67%, specificity 66%), while β-hCG alone showed high specificity (87%) but poor sensitivity (29%).

Despite heterogeneity among studies, publication bias was not significant. The findings indicate that while neither biomarker is sufficient for independent diagnosis, their integration into early risk models could enhance prediction and enable proactive management of GDM. Further large-scale, standardized trials are needed to validate their role in early pregnancy screening.