Low pregnancy associated plasma protein-A in the 1st trimester: Is it a predictor of poor perinatal outcome?

Abstract

The objective of the study was to examine the predictive value of pregnancy associated plasma protein-A (PAPP-A) as a marker of poor pregnancy outcome. Databases at the University Hospital Lewisham, were used retrospectively to identify singleton pregnancies, which underwent 1st trimester combined screening between July 2008 and April 2010 and were found to have PAPP-A levels ≤ 0.4MoM. The perinatal courses of these pregnancies (n = 315) were evaluated for signs of adverse perinatal outcome and compared with a matched control group of pregnancies (n = 330) with normal PAPP-A levels. Results showed that women with low serum PAPP-A were at increased risk of adverse pregnancy outcome compared with the control group (OR 2.4, p = 000.1). They were also more likely to suffer fetal loss (OR 6.2, p = 0.001) in the form of miscarriage (OR 2.7, p = 0.110) and stillbirth (OR 2.4, p = 0.001). It was concluded that serum PAPP-A is a marker for poor pregnancy outcome and women with low serum PAPP-A levels would benefit from increased monitoring of their pregnancies.

Keywords::

• Antenatal care
• 1st trimester screening
• PAPP-A
• perinatal outcome
• placental insufficiency

Acknowledgements

Authors would like to thank Mr Victor Zurkowski for assistance with the statistical analysis and Mrs Sue Percival for her help in data collection.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.