Association between first‐trimester maternal serum pregnancy‐associated plasma protein‐A and obstetric complications

Abstract

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.

Promising prognostic markers of Preeclampsia: New avenues in waiting

“…interleukin-1β (IL-1β) in the first trimester of pregnancy as predictive markers, but these molecules showed poor to moderate predictive value for PE [25]. [28].…”

Maternal Serum PAPP-A as an Early Marker of Obstetric Complications?

“…IUGR, PTD and GD, we failed to demonstrate any significant differences between the two groups, even if an increase of low PAPP-A levels in these diseases without reaching statistical significance was shown. However, using a PAPP-A MoM value similar to ours, other researchers [1,2] found significant differences in pre-term births and IUGR, with an OR value varying from 3 to 4. Also for GD, first-trimester PAPP-A values were significantly lower in women who subsequently developed GD, compared to a control group [3]; furthermore, serum PAPP-A concentrations correlated independently and inversely with subsequent GD.…”

“…At similar MoM cutoff values, the risk of GH and PE was slightly increased in our work compared to that of Dugoff et al [2]: OR 2.1 vs. 1.64 and 2.5 vs. 1.79, respectively. In a recent study by D'Antonio et al [1], in which 296 PE women were evaluated, the PAPP-A level was <3rd centile which corresponds to 0.34 MoM, the OR calculated was 2.2 which is not different from ours (OR 2.5), but if only the early PE was considered the OR reached 9.4, suggesting the importance of this marker for the most severe cases. The same group has recently demonstrated that first-trimester PAPP-A MoM values were directly correlated with gestational age at delivery [7].…”

“…It is usually used in the screening test for Down's syndrome, performed between 11 and 13 +6 weeks of gestation. Some studies have demonstrated that low first-trimester PAPP-A may be associated with an adverse outcome of pregnancy, such as preeclampsia [1], intrauterine growth restriction [1], pregnancy loss [2], pre-term delivery [1], and gestational diabetes [3]. Adverse outcomes of pregnancy have an important impact on social, emotional, and public health, therefore many studies have been oriented towards prevention and early identification of patients at risk.…”

Maternal Serum Aneuploidy Screen and Adverse Pregnancy Outcomes

“…The use of maternal serum screening solely to predict and prevent these outcomes has not been supported due to overall low sensitivity and high false-positive rates [11,12]. D'Antonio et al [13] reported that maternal serum PAPP-A performs poorly as a screening test for PT, SGA and preeclampsia. The ROC analysis showed that the AUC under the ROC curve in this analysis for PAPP-A to predict LBW and PT was 0.7 and 0.68, respectively, indicating that it has a ''fair'' predictive accuracy [14].…”