First-trimester maternal serum PAPP-A and free-beta subunit human chorionic gonadotropin concentrations and nuchal translucency are associated with obstetric complications: A population-based screening study (The FASTER Trial)

Dugoff, Lorraine; Hobbins, John C.; Malone, Fergal D.; Porter, T. Flint; Luthy, David A.; Comstock, Christine H.; Hankins, Gary D.V.; Berkowitz, Richard L.; Merkatz, Irwin R.; Craigo, Sabrina; Timor‐Tritsch, I. E.; Carr, S. R.; Wolfe, Honor M.; Vidaver, John; D’Alton, Mary E.

doi:10.1016/j.ajog.2004.06.052

Cited by 568 publications

(535 citation statements)

References 24 publications

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“…In this study, PAPP-A levels of ≤0.3 MoM were predictive of increased risk of low birth weight and premature birth. Increased risk of low birth weight, intrauterine growth retardation and premature birth in women with low PAPP-A has been noted by others (Dugoff et al, 2004;Kabili et al, 2004;Krantz et al, 2004). In contrast, other studies have found an association between low PAPP-A and increased risk of low birth weight or intrauterine growth retardation, but not with preterm birth (Ong et al, 2000;Yaron et al, 2002a;Kwik and Morris, 2003;Tul et al, 2003).…”

Section: Low Papp-a and Adverse Outcomesmentioning

confidence: 65%

“…This cut-off was chosen in view of work by Krantz et al (2004) and Dugoff et al (2004) who examined PAPP-A at <1st and 5th centiles in women screened with combined FTS. In these articles the 1st centile was equivalent to 0.29 and 0.28 MoM respectively and the 5th centile was equivalent to 0.44 and 0.42 MoM respectively.…”

Section: Methodsmentioning

confidence: 99%

“…Most literature has focused on the individual components of the screen; increased fetal NT (Adekunle et al, 1999;Souka et al, 2001;Cheng et al, 2004;Dugoff et al, 2004;Kabili et al, 2004;Krantz et al, 2004), low maternal PAPP-A (Ong et al, 2000;Ochshorn et al, 2001;Yaron et al, 2002a;Kwik and Morris, 2003;Dugoff et al, 2004;Kabili et al, 2004;Krantz et al, 2004) and abnormal free *Correspondence to: Sandie L. Barrett, Western Diagnostic Pathology, Symbion Health, Western Australia, Australia. E-mail: sandieb@aapt.net.au β-hCG levels (Ong et al, 2000;Yaron et al, 2002b;Dugoff et al, 2004;Kabili et al, 2004;Krantz et al, 2004) and their associations with adverse pregnancy outcomes. However, there is less information on the capacity of the combined first-trimester screen result to predict pregnancies at increased risk of adverse fetal outcome.…”

Section: Introductionmentioning

confidence: 99%

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Use of the combined first‐trimester screen result and low PAPP‐A to predict risk of adverse fetal outcomes

Barrett¹,

Bower

Hadlow³

2008

Prenatal Diagnosis

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ObjectivesTo investigate associations between combined first‐trimester screen result, pregnancy associated plasma protein‐A (PAPP‐A) level and adverse fetal outcomes in women.MethodsPregnancy outcomes for 10 273 women participating in a community based first‐trimester screening (FTS) programme in Western Australia were ascertained by record linkage to birth and birth defect databases. A first‐trimester risk cut‐off of ≥ 1 in 300 defined screen positive women.ResultsScreen positive pregnancies were more likely to have Down syndrome and birth defects (chromosomal or nonchromosomal) than screen negative pregnancies. When birth defects were excluded, screen positive pregnancies were at increased risk of pregnancy loss, low birth weight and preterm birth. Pregnancies with low PAPP‐A (⩽0.3 multiples of the median (MoM)) had higher risk of chromosomal abnormality, birth defect, preterm birth, low birth weight, or pregnancy loss, compared to those with PAPP‐A > 0.3 MoM. In pregnancies without birth defects, low PAPP‐A was a stronger predictor of preterm birth, low birth weight or pregnancy loss than a screen positive result.ConclusionsWomen with positive screen or low PAPP‐A were at increased risk for some adverse fetal outcomes. The sensitivity of these parameters was insufficient to support primary screening, but increased surveillance during pregnancy may be appropriate. Copyright © 2008 John Wiley & Sons, Ltd.

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Section: Low Papp-a and Adverse Outcomesmentioning

confidence: 65%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Use of the combined first‐trimester screen result and low PAPP‐A to predict risk of adverse fetal outcomes

Barrett¹,

Bower

Hadlow³

2008

Prenatal Diagnosis

View full text Add to dashboard Cite

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“…First trimester screening done in our Case 2 showed low PAPP-A. However, this finding is non-specific and has been associated with a number of conditions and adverse fetal outcomes including preterm birth, preeclampsia, low birth weight and pregnancy loss (Dugoff et al, 2004;Barrett et al, 2008). The cystic hygroma detected in our first case has been associated with a variety of conditions including aneuploidy, pregnancy loss and genetic syndromes such as Noonan syndrome (Malone et al, 2005).…”

Section: Discussionmentioning

confidence: 91%

Cornelia de Lange syndrome (CdLS): prenatal and autopsy findings

et al. 2009

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Cornelia de Lange Syndrome (CdLS) is a multisystem disorder characterized by somatic defects and mental retardation. Prenatal diagnosis of this severe condition is difficult in view of the non-specific ultrasound abnormalities. We report three cases with prenatally suspected CdLS based on the ultrasound findings as well as low PAPP-A detected on first trimester screening in one case, and the results of the autopsy and the NIPBL gene mutation analysis.

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“…12,13 In the largest series to date, PAPP-A data from 34 271 pregnancies obtained between 10 and 14 weeks gestation showed a very strong association between low PAPP-A levels in the first trimester and several adverse outcomes of pregnancy. 14,15 PAPP-A had been identified by mass spectrometry microsequencing as the Insulin Growth Factor (IGF)-dependent Binding Protein (IGFBP)-4-specific protease 16 from human fibroblast-conditioned media. 17 Recently, PAPP-A was demonstrated to be a metzincin superfamily metalloproteinase involved in normal and pathological IGF physiology.…”

Section: Introductionmentioning

confidence: 99%

PAPP-A levels as an early marker of idiopathic preterm birth: a pilot study

et al. 2007

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Objective: To evaluate late PAPP-A levels as predictive of preterm birth in symptomatic women.Study Design: Prospective cohort study of singleton gestations, 23 to 34 weeks, and symptoms of preterm labor. PAPP-A, IGF-I and IGF-III analysis were performed. Primary end point was delivery p7 days. Accuracy and optimally predictive PAPP-A values were based on receiver operator characteristic (ROC) curves.Result: In all, 26 women (51%) delivered p7 days post-admission (Group 1); 25 women (49%) >7 days (Group 2). Group 1 mean PAPP-A ¼ 38 000 vs 55 333 for Group 2 (P<0.04). Group 1 mean gestational age at delivery ¼ 29 weeks vs 37 weeks for Group 2 (P<0.00014). PAPP-A level p30 000 mU l À1 had highest specificity (88%), sensitivity (50%), and positive predictive (81%) and negative predictive (62%) values for delivery p7 days. ROC area under curve ¼ 0.703.Conclusion: PAPP-A levels p30 000 mU l À1 at admission was associated with increased risk for preterm birth p7 days, supporting active management and therapeutic approach in these women.

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First-trimester maternal serum PAPP-A and free-beta subunit human chorionic gonadotropin concentrations and nuchal translucency are associated with obstetric complications: A population-based screening study (The FASTER Trial)

Cited by 568 publications

References 24 publications

Use of the combined first‐trimester screen result and low PAPP‐A to predict risk of adverse fetal outcomes

Use of the combined first‐trimester screen result and low PAPP‐A to predict risk of adverse fetal outcomes

Cornelia de Lange syndrome (CdLS): prenatal and autopsy findings

PAPP-A levels as an early marker of idiopathic preterm birth: a pilot study

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