Association between first‐trimester maternal serum pregnancy‐associated plasma protein‐A and obstetric complications. (10th July 2013)

• Record Type: Journal Article
• Authors: D'Antonio, Francesco; Rijo, Claudia; Thilaganathan, Basky; Akolekar, Ranjit; Khalil, Asma; Papageourgiou, Aris; Bhide, Amar
• Is Part Of: Prenatal diagnosis. Volume 33:Number 9(2013:Sep.)
• Page Start: 839
• Page End: 847
• Publication Date: 2013-07-10
• Subjects: Prenatal diagnosis -- Periodicals; Fetus -- Diseases -- Diagnosis -- Periodicals; Electronic journals; 618.32075
• DOI: 10.1002/pd.4141
• Languages: English
• ISSNs: 0197-3851

Abstract

<abstract abstract-type="main"> <title>ABSTRACT</title> <sec id="pd4141-sec-0001" sec-type="section"> <title>Objective</title> <p>This study aimed to investigate the relationship between maternal serum pregnancy‐associated plasma protein‐A (PAPP‐A) in the first trimester of pregnancy and the development of preeclampsia (PE), early PE, small‐for‐gestational age (SGA) fetus and preterm delivery (PD).</p> </sec> <sec id="pd4141-sec-0002" sec-type="section"> <title>Method</title> <p>This is a retrospective study of 12 355 pregnant women that delivered between 2008 and 2011. We define the first, third and fifth percentiles of maternal serum PAPP‐A multiples of the median (MoM). The primary outcome measures were the occurrence of PE, early PE (PE requiring delivery before 34 weeks), SGA fetus (birth weight < 5th centile) and PD. The Mann–Whitney <italic>U</italic>‐test and chi‐squared test were used to analyze continuous and dichotomous variables, respectively.</p> </sec> <sec id="pd4141-sec-0003" sec-type="section"> <title>Results</title> <p>Maternal serum PAPP‐A was significantly lower in women with PE, early PE, SGA fetus and PD (0.91, 0.74, 0.80 and 0.84 MoM, respectively) than in the study population (0.99 MoM) (<italic>p</italic> < 0.05). The lower the MoM percentile of PAPP‐A, the higher are the odds ratio (OR) to develop PE, early PE, SGA fetus and PD.</p> </sec> <sec id="pd4141-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Maternal serum PAPP‐A levels are lower in women who develop preeclampsia, those with SGA fetus and those who deliver preterm. However, on its own, maternal serum PAPP‐A performs poorly (OR for PE between 1.76 and 2.41 with the lower percentile of PAPP‐A) as a screening test for these conditions. © 2013 John Wiley & Sons, Ltd.</p> </sec> </abstract>