Correlation of first-trimester serum levels of pregnancy-associated plasma protein A with small-for-gestational-age neonates and preterm births.
OBJECTIVE
To analyze the relationship between first-trimester levels of pregnancy-associated plasma protein A (PAPP-A) and small-for-gestational-age (SGA) neonates and preterm births, and to assess predictive utility for these events.


METHODS
A prospective study was conducted among women undergoing first-trimester screening between January 1, 2012, and December 31, 2013, at two centers in Pune, India. Serum PAPP-A levels, pregnancy course, and outcome were assessed.


RESULTS
Overall, 1474 women were included. An association was found between the lowest quintile of PAPP-A levels (<0.4 multiples of median) for both SGA (<10th centile; 20.9% of cases in this PAPP-A quintile) and preterm birth (<37weeks; 15.8%). Women in the lowest quintile of PAPP-A concentration had a significantly increased risk of SGA (<10th centile) than did those with higher concentrations (adjusted odds ratio 2.92, 95% confidence interval 2.00-4.27). Their risk of preterm birth (<37weeks) was also increased (adjusted odds ratio 1.84, 95% confidence interval 1.25-2.72). The predictive sensitivities of the lowest quintile of PAPP-A were 35.85% for SGA (<10th centile) and 27.92% for preterm birth (<37weeks).


CONCLUSION
Low levels of PAPP-A were associated with SGA and preterm births; however, poor predictive sensitivity could restrict clinical utility of this marker when used alone.
['Gundu|Shridevi|S|', 'Kulkarni|Mohan|M|', 'Gupte|Sanjay|S|', 'Gupte|Asmita|A|', 'Gambhir|Maitreyee|M|', 'Gambhir|Prakash|P|']
D000328:Adult D015415:Biomarkers D018997:Chorionic Gonadotropin, beta Subunit, Human D005260:Female D005317:Fetal Growth Retardation D005865:Gestational Age D006801:Humans D007194:India D007231:Infant, Newborn D007236:Infant, Small for Gestational Age D016015:Logistic Models D011247:Pregnancy D011256:Pregnancy Outcome D011261:Pregnancy Trimester, First D011266:Pregnancy-Associated Plasma Protein-A D047928:Premature Birth D011296:Prenatal Diagnosis D011446:Prospective Studies
Pregnancy-associated plasma protein A Preterm birth Pregnancy Small for gestational age