PAPPA and diabetes mellitus: In this context, the single or combined use of several prediction tools, including pregnancy-associated plasma protein-A (PAPP-A), maternal mean arterial pressure (MAP), serum levels of placental growth factor (PlGF), uterine artery pulsatility index, and maternal demographic factors—including age, history of PE, diabetes mellitus (DM), and body mass index (BMI)—has been extensively investigated [4, 5].