Maymon R, et al. - Maternal serum screening markers in the first and second trimester twin pregnancies, which subsequently developed gestational diabetes mellitus (GDM) were investigated. For this purpose, they recruited 145 twin pregnancies in the first trimester. From 11 twins, 20 samples of first and second trimester were available who subsequently developed GDM and 219 samples from unaffected twins. The affected twins displayed the median pregnancy-associated plasma protein (PAPP)-A level of 3.61 MoM (multiples of the gestation-specific median) compared with 2.46 MoM observed in unaffected twins; significant results were found in both trimesters. They also noted an increase in median placental protein (PP)13 but to a lesser extent. As per logistic regression, combining PAPP-A and maternal weight had a 55% detection rate for a 10% false-positive rate. Findings thus suggest the utility of evaluation of early prenatal marker in twin pregnancies for predicting the risk for developing GDM.