Maternal serum placental growth factor and pregnancy-associated plasma protein A measured in the first trimester as parameters of subsequent pre-eclampsia and small-for-gestational-age infants: A prospective observational study

Abstract

ObjectiveTo examine the first-trimester maternal serum placental growth factor (PlGF) and pregnancy-associated plasma protein A (PAPP-A) levels in pregnancies associated with pre-eclampsia (PE) or small-for-gestational-age (SGA) infants, and determine the predictive accuracy of PlGF and of PAPP-A for either PE or SGA infants.MethodsThis prospective, observational study included 175 pregnant women, and of these women, due to participant withdrawal or loss to follow-up, delivery data were collected from the medical records of 155 women, including 4 who had twin pregnancies. The women's maternal history was recorded, and the PlGF and PAPP-A levels at 11 to 13 gestational weeks were measured. During the second trimester, the maternal uterine artery's systolic/diastolic ratio was measured. Multiples of the median (MoM) of PlGF and PAPP-A were determined, and the associations of these values with the risk factors of SGA and PE were evaluated. Logistic regression analysis was used to determine whether PlGF and PAPP-A are useful markers for predicting SGA infants.ResultsThe PAPP-A MoM level was significantly lower in women with advanced maternal age, multipara women, and women with gestational diabetes than in their counterparts. The PlGF and PAPP-A MoM levels were higher in women with a twin pregnancy than in those with a singleton pregnancy. There was a significant relationship between the maternal serum PAPP-A MoM level in the first trimester and the uterine artery systolic/diastolic ratio in the second trimester. Results of logistic regression analysis showed that low PlGF and PAPP-A MoM levels were predictors of SGA infants (odds ratio, 0.143; 95% confidence interval, 0.025 to 0.806; odds ratio, 0.191; 95% confidence interval, 0.051 to 0.718, respectively).ConclusionPlGF and PAPP-A are potentially useful as first-trimester markers for SGA infants and some hypertensive disorders of pregnancy.

Syncytiotrophoblast extracellular microvesicle profiles in maternal circulation for noninvasive diagnosis of preeclampsia

“…Early diagnosis would enable closer monitoring and treatment of this condition, and may open the window for earlier intervention that might help reduce the associated risks to the fetus and the mother. In addition to investigations studying circulating free proteins and microRNAs for their biomarker potential, plasma extracellular vesicles, including exosomes, have been extensively studied in many medical fields for their diagnostic potential [38][39][40][41][42][43][44][45][46][47][48][49][50] .…”

“Screening for small-for-gestational age neonates at early third trimester in a high-risk population for preeclampsia”

“…The relationship of lower MAP with SGA may be attributed to its positive correlation with BMI [25]. About mean UtA PI, maternal characteristics and biochemical markers, several studies have demonstrated differences on pregnancies with SGA neonates at 11-13 weeks [26][27][28]. However, it is well known that first trimester screening of SGA neonates performs poorer than the screening for Preeclampsia [29,30].…”

Serum Galectin-3 Levels Are Unlikely to Be a Useful Predictive Marker for Early-onset Preeclampsia Development

“…Currently many biomarkers for early detection and prognosis of preeclampsia are investigated. The most widely used markers in clinical practice are: placental growth factor (PLGF) (Tsiakkas et al, 2015;Sung et al, 2017) and serum pregnancy-associated plasma protein-A (PAPP-A) (Kalousová et al, 2014;Patil et al, 2014). Unfortunately, their sensitivity and specificity is low yet.…”