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Abstract
Objective: Preeclampsia is one of the major issues in maternal–fetal medicine. Early risk stratification may be beneficial, so is the aim of several researches. Our goal is to investigate whether PAPP-A MoM calculated for first trimester Down's syndrome screening or MoM calculated according to Ong’s formula can be used to predict the risk of preeclampsia or do we need another method to calculate PAPP-A MoM derived from non preeclamptic cases. Study Design: For this retrospective study, data of randomly selected 150 singleton pregnant women who did not develop preeclampsia are used to create a formula to calculate median value of PAPP-A. PAPP-A values of this subgroup are plotted against gestational age and curve fit analysis is done to determine best fitted regression line to get a formula to calculate median value of our cases. PAPP-A MoM values are calculated for each subject according to Ong’s formula and our formula. We already had MoM values derived from first trimester screening. ROC curve and Delong’s pairwise comparison analyses are used to investigate which MoM value is more predictive for preeclampsia.Results: Although the area under curve value of MoM values derived from this study was the highest, DeLong’s pairwise comparison analysis showed no statistically significant difference between the three curves. Conclusion: PAPP-A MoM calculation specific to preeclampsia does not seem to be necessary; PAPP-A MoM obtained from first trimester aneuploidy scan can be used to predict preeclampsia.
Highlights
Preeclampsia (PE) affects approximately 5% of all pregnancies and remains a significant cause of maternal and neonatal morbidity and mortality [1]
Pregnancy Associated Plasma Protein A (PAPP-A) Multiples of Median (MoM) calculation specific to preeclampsia does not seem to be necessary; PAPP-A MoM obtained from first trimester aneuploidy scan can be used to predict preeclampsia
Subjects in Ong’s research were pregnancies affected by miscarriage, proteinuric and non proteinuric pregnancy induced hypertension, preterm delivery, growth restriction, and gestational diabetes [7]. The aim of this present study is to investigate whether PAPP-a MoM calculated for first trimester Down syndrome screening or MoM calculated according to Ong’s formula can be used to predict the risk of preeclampsia, or do we need another method to calculate PAPP-A MoM value derived from non preeclamptic cases only, without excluding cases with other adverse pregnancy outcomes
Summary
Preeclampsia (PE) affects approximately 5% of all pregnancies and remains a significant cause of maternal and neonatal morbidity and mortality [1]. Recent studies [2,3,4,5,6] have argued that the new approach in screening for preeclampsia is the incorporation of data coming from maternal characteristics, previous obstetric history and biochemical markers. Several markers have been evaluated regarding to their ability to predict preeclampsia in the first trimester, prior to onset of clinical signs. One of these markers is Pregnancy Associated Plasma Protein A (PAPP-A). First trimester serum level of PAPP-A is Submitted for Publication: 26.07.2016 Accepted for Publication: 24.10.2016 lower in preeclamptic women [7,8,9,10]. The median Multiples of Median (MoM) of maternal serum PAPPA was significantly lower in women with small for gestational age [7,10], preterm delivery [7,10], premature delivery [8], and stillbirth [8]
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