Association between first-trimester maternal level of pregnancy-associated plasma protein-A and adverse pregnancy outcomes

Abstract

Objectives To study the association between low first-trimester pregnancy-associated plasma protein-A (PAPP-A) and adverse pregnancy outcomes. Background PAPP-A is produced by the placenta during pregnancy. Low plasma level of this protein has been suggested as a biochemical marker for pregnancies with aneuploidy fetuses. Other studies found associations between low PAPP-A and adverse pregnancy outcomes during the first-trimester screening. Patients and methods The present study was conducted at Al-Amrya General Hospital, Gynecology and Obstetrics Department, after informed consent from participants was taken. The research ethics committee at Faculty of Medicine, Menoufia University, approved it. The study included 90 pregnant women booked for routine antenatal care while they were in their first-trimester after fulfilling the inclusion criteria. A blood sample (3–4 ml of venous blood) was withdrawn from all study participants. Then, samples were collected in plain tubes, followed by centrifugation of the samples, where the sera were collected for PAPP-A assay and stored at −20°C. Actual assay of PAPP-A would not be done except after development of any of adverse pregnancy outcome, including preeclampsia, gestational hypertension, intrauterine growth restriction, intrauterine fetal death, or spontaneous preterm. Results There is an association between low PAPP-A less than or equal to 0.41 in the first-trimester and development of adverse pregnancy outcomes. Conclusion Maternal serum PAPP-A level was significantly lower during the first-trimester in women who developed adverse pregnancy outcomes than women who did not develop.