Dereke J, et al. - Researchers conducted this investigation to ascertain if pregnancy-associated plasma protein-A2 levels are increased in early pregnancies complicated by gestational diabetes and if gestation age influences levels, as well as to examine the possible use of pregnancy-associated plasma protein-A2 as a prescreening biomarker to lessen the requirement for performing oral glucose tolerance tests in pregnant women. In early pregnancy, pregnant women were diagnosed with gestational diabetes after a 2-hour 75 g oral glucose tolerance test in the Skåne University Hospital, Lund, Sweden catchment area in 2011–2015 (n = 99). During 2014–2015, age- and BMI-matched pregnant women without diabetes were recruited from maternal health centers in the same geographical area to act as controls at similar gestational ages (n = 100). Using commercially available enzyme-linked immunosorbent assay kits, circulating pregnancy-associated plasma protein-A2 was analysed in participant serum. In women diagnosed with gestational diabetes vs controls, circulating pregnancy-associated plasma protein-A2 has been increased. This is the first study showing increased levels of plasma protein-A2 associated with pregnancy in gestational diabetes. As a prescreening biomarker, pregnancy-associated plasma protein-A2 also demonstrates promise with the ability to decrease the need for early pregnancy oral glucose tolerance tests. However, in order to further verify this observation, future prospective cohort studies in a larger group of high- and low-risk females are required.