Pregnancy-associated plasma protein A in the prediction of early pregnancy failure

Westergaard, J.G.; Sinosich, Michael J.; Bugge, Merete; Madsen, Lydia T.; Teisner, B.; Grudzinskas, J. G.

doi:10.1016/0002-9378(83)90341-1

Cited by 76 publications

(24 citation statements)

References 9 publications

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“…In these compromised pregnancies, marker levels were depressed, confirming earlier reports which demonstrated a strong relationship between depressed PAPP-A levels and poor pregnancy outcome (Sinosich et al, , 1985Westergaard et al, 1983;Brambati et al, 1991), since marker levels were also depressed in trisomy 18, thus indicating a compromised feto-placental unit. In contrast, DS pregnancies showed a unique PAPP-A/F -hCG profile, with PAPP-A being markedly depressed (median 0·43 MoM) and F -hCG significantly elevated (median 2·06 MoM).…”

Section: Discussionsupporting

confidence: 87%

Prenatal screening in the first trimester of pregnancy

Wheeler

Sinosich

1998

Prenat. Diagn.

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Section: Discussionsupporting

confidence: 87%

Prenatal screening in the first trimester of pregnancy

Wheeler

Sinosich

1998

Prenat. Diagn.

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“…A decrease in PAPP-A levels is now considered to be a marker of problems in pregnancy [6,8], and this discrepancy may be due to small numbers involved (because some measurements were below the limit of detection and so did not contribute to the analysis), or due to the fact that the pregnancies had already failed [53-55]. There was, however, a strong correlation between P4, β-hCG and PAPP-A levels in both viable and non-viable pregnancies, suggesting a causal link in the production of each of these factors.…”

Section: Discussionmentioning

confidence: 99%

Modulation of the endocannabinoid system in viable and non-viable first trimester pregnancies by pregnancy-related hormones

Taylor

Finney

Lam

et al. 2011

Reprod Biol Endocrinol

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BackgroundIn early pregnancy, increased plasma levels of the endocannabinoid anandamide (AEA) are associated with miscarriage through mechanisms that might affect the developing placenta or maternal decidua.MethodsIn this study, we compare AEA levels in failed and viable pregnancies with the levels of the trophoblastic hormones (beta-human chorionic gonadotrophin (beta-hCG), progesterone (P4) and (pregnancy-associated placental protein-A (PAPP-A)) essential for early pregnancy success and relate that to the expression of the cannabinoid receptors and enzymes that modulate AEA levels.ResultsThe median plasma AEA level in non-viable pregnancies (1.48 nM; n = 20) was higher than in viable pregnancies (1.21 nM; n = 25; P = 0.013), as were progesterone and beta-hCG levels (41.0 vs 51.5 ng/mL; P = 0.052 for P4 and 28,650 vs 6,560 mIU/L; P = 0.144 for beta-hCG, respectively, but were not statistically significant). Serum PAPP-A levels in the viable group were approximately 6.8 times lower than those in the non-viable group (1.82 vs 12.25 mg/L; P = 0.071), but again these differences were statistically insignificant. In the spontaneous miscarriage group, significant correlations between P4 and beta-hCG, P4 and PAPP-A and AEA and PAPP-A levels were observed. Simultaneously, immunohistochemical distributions of the two main cannabinoid receptors and the AEA-modifying enzymes, fatty acid amide hydrolase (FAAH) and N-acylphosphatidylethanolamine-phospholipase D (NAPE-PLD), changed within both the decidua and trophoblast.ConclusionsThe association of higher AEA levels with early pregnancy failure and with beta-hCG and PAPP-A, but not with progesterone concentrations suggest that plasma AEA levels and pregnancy failure are linked via a mechanism that may involve trophoblastic beta-hCG, and PAPP-A, but not, progesterone production. Although the trophoblast, decidua and embryo contain receptors for AEA, the main AEA target in early pregnancy failure remains unknown.

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“…The potential use of PAPP‐A in the prediction of early pregnancy failure was first recognised over 20 years ago by Westergaard et al 22, when they established that at 8 to 14 weeks of pregnancy, levels of PAPP‐A were less than the 10 th centile of normal in women who showed ultrasonic evidence of fetal life at the time of the investigation. They concluded that the measurement of maternal serum PAPP‐A may be of value in the management of threatened abortion, particularly in patients in whom ultrasound examination was normal.…”

Section: Discussionmentioning

confidence: 99%