Association of the Low Pregnancy-Associated Plasma Protein A and Pregnancy Complications in the First Trimester: A Prospective Cohort Study
School of Medicine Students' Journal,
Vol. 2 No. 4 (2020),
,
Page 1-4
https://doi.org/10.22037/smsj.v2i4.23230
Abstract
Background and Aims: This study aimed to assess the association between the low maternal serum of pregnancy-associated plasma protein-A (PAPP-A) during the first trimester and pregnancy outcomes.
Materials and Methods: We conducted a prospective cohort study of 118 pregnant women undergoing first-trimester screening between 2016 and 2017 at Taleghani and Imam Hussein hospital in Tehran, Iran. We recorded demographic data and blood samples were to analyze the value of PAPP-A, based on which we divided the participants into two groups: PAPP-A>10 percentile as a control group and PAPP-A≤10th percentile as a study group. The pregnancies underwent follow-up observations for obstetric complications during pregnancy. Chi-square or Fisher exact test and Mann-Whitney U test were applied to analyze data by SPSS 26.
Results: In this study,118 pregnant women were enrolled. Our results show a significant association between low PAPP-A (<10th percentile) and preterm labor, small for gestational age (SGA), hypertension, preeclampsia (P<0.05), but no statistically significant difference was found between low PAPP-A and stillbirth. Demographic data, including age, gravida, parity, BMI, had no relationship with low PAPP-A, significantly (P>0.05).
Conclusion: Low PAPP-A is associated with adverse outcomes; thus, measuring the PAPP-A within the first trimester is suggested for timely management.
- pregnancy-associated plasma protein-A
- PAPP-A
- Pregnancy Complication
- First Trimester
- Preeclampsia
- small for gestational age
- preterm labor
- SGA
How to Cite
References
Pummara P, Tongsong T, Wanapirak C, Sirichotiyakul S, Luewan S. Association of first-trimester pregnancy-associated plasma protein A levels and idiopathic preterm delivery: A population-based screening study. Taiwan J Obstet Gynecol. 2016;55(1):72–5.
Hanita O, Roslina O, Azlin MIN. Maternal level of pregnancy-associated plasma protein A as a predictor of pregnancy failure in threatened abortion. Malays J Pathol. 2012;34(2):145–51.
She B, Chen S, Lee F, Cheong M, Tsai M. L OW M ATERNAL S ERUM L EVELS OF P REGNANCY - ASSOCIATED P LASMA P ROTEIN -A D URING THE F IRST TRIMESTER ARE A SSOCIATED WITH SUBSEQUENT P PRETERM DELIVERY WITH PRETERM P PREMATURE RUPTURE OF MEMBRANES. 2007;46(3):242–7.
Sotiriadis A, Figueras F, Eleftheriades M, Papaioannou GK. First-trimester and combined first- and second-trimester prediction of small-for-gestational-age and late fetal growth restriction.
Antonio FD, Rijo C, Thilaganathan B, Akolekar R, Khalil A, Papageorgiou A, et al. Association between first-trimester maternal serum pregnancy-associated plasma protein-A, and obstetric complications. 2013;
Report S. The use of ultrasound and other markers for early detection of preeclampsia. 2016;12:199–207.
Bartels HC, Postle JD, Downey P, Brennan DJ. Placenta accreta spectrum: A review of pathology, molecular biology, and biomarkers. Dis Markers. 2018;2018.
Vikraman SK, Elayedatt RA. Pre-eclampsia screening in the first trimester – preemptive action to prevent the peril. J Matern Neonatal Med [Internet]. 2020;0(0):1–9. Available from: https://doi.org/10.1080/14767058.2020.1767059
Wu P, Berg C Van Den, Alfirevic Z, Brien SO. Early Pregnancy Biomarkers in Pre-Eclampsia : A Systematic Review and Meta-Analysis. 2015;23035–56.
Hughes AE, Sovio U, Gaccioli F, Cook E, Charnock-jones DS, Smith GCS. The association between fi rst trimester AFP to PAPP-A ratio and placentally- related adverse pregnancy outcome. Placenta [Internet]. 2019;81(January):25–31. Available from: https://doi.org/10.1016/j.placenta.2019.04.005
Gupta S, Goyal M, Verma D, Sharma A, Bharadwaj N, Kabra M, et al. Adverse pregnancy outcome in patients with low pregnancy-associated plasma protein-A : The Indian Experience. 2015;41(7):1003–8.
Akolekar R, Machuca M, Mendes M, Paschos V, Nicolaides KH. Prediction of stillbirth from placental growth factor at 11–13 weeks. Ultrasound Obstet Gynecol. 2016;48(5):618–23.
Dugoff L, Hobbins JC, Malone FD, Porter TF, Luthy D, Comstock CH, et al. First-trimester maternal serum PAPP-A and free-beta subunit human chorionic gonadotropin concentrations and nuchal translucency are associated with obstetric complications: A population-based screening study (The FASTER Trial). Am J Obstet Gynecol. 2004;191(4):1446–51.
Dascau V, Furau G, Pilat L, Onel C, Puschita M. Screening for hypertensive pregnancy complications through maternal serum PAPP-A 5th and 10th percentiles during the 11-14 weeks gestational age interval. Rev Chim. 2020;71(2):262–6.
Antwi E, Klipstein-Grobusch K, Browne JL, Schielen PC, Koram KA, Agyepong IA, et al. Improved prediction of gestational hypertension by inclusion of placental growth factor and pregnancy associated plasma protein-a in a sample of Ghanaian women. Reprod Health. 2018;15(1):1–10.
Inan C, Varol FG, Erzincan SG, Uzun I, Sutcu H, Sayin NC. Use of prokineticin-1 (PROK1), pregnancy-associated plasma protein A (PAPP-A) and PROK1/PAPP-A ratio to predict adverse pregnancy outcomes in the first trimester: a prospective study. J Matern Neonatal Med. 2018;31(20):2685–92.
Allen R, Aquilina J. Prospective observational study to determine the accuracy of first-trimester serum biomarkers and uterine artery Dopplers in combination with maternal characteristics and arteriography for the prediction of women at risk of preeclampsia and other adverse . J Matern Neonatal Med. 2018;31(21):2789–806.
Luewan S, Teja-Intr M, Sirichotiyakul S, Tongsong T. Low maternal serum pregnancy-associated plasma protein-A as a risk factor of preeclampsia. Singapore Med J. 2018;59(1):55–9.
Poon LCY, Maiz N, Valencia C, Plasencia W, Nicolaides KH. First-trimester maternal serum pregnancy-associated plasma protein-A and pre-eclampsia. Ultrasound Obstet Gynecol. 2009;33(1):23–33.
Honarjoo M, Kohan S, Zarean E, Tarrahi MJ. Assessment of β-human-derived chorionic gonadotrophic hormone (βhCG) and pregnancy-associated plasma protein A (PAPP-A) levels as predictive factors of preeclampsia in the first trimester among Iranian women: A cohort study. BMC Pregnancy Childbirth. 2019;19(1):4–8.
Hoseini MS, Sheibani S, Sheikhvatan M. The evaluating of pregnancy-associated plasma protein-A with the likelihood of small for gestational age. Obstet Gynecol Sci. 2020;63(3):225–30.
Malik J, Rai P, Das A, Das S. Pregnancy-associated plasma protein A - a level in first trimester and its impact on pregnancy outcome. Int J Reprod Contraception, Obstet Gynecol. 2016;5(8):2680–3.
Gundu S, Kulkarni M, Gupte S, Gupte A, Gambhir M, Gambhir P. Correlation of first-trimester serum levels of pregnancy-associated plasma protein A with small-for-gestational-age neonates and preterm births. Int J Gynecol Obstet [Internet]. 2016;133(2):159–63. Available from: http://dx.doi.org/10.1016/j.ijgo.2015.09.022
Pakniat H, Bahman A, Ansari I. The Relationship of Pregnancy-Associated Plasma Protein A and Human Chorionic Gonadotropin with Adverse Pregnancy Outcomes: A Prospective Study. J Obstet Gynecol India. 2019;69(5):412–9.
Morris RK, Bilagi A, Devani P, Kilby MD. Association of serum PAPP-A levels in first trimester with small for gestational age and adverse pregnancy outcomes: systematic review and meta-analysis. Prenat Diagn. 2017;37(3):253–65.
Poon LC, Nicolaides KH. Early Prediction of Preeclampsia. Obstet Gynecol Int. 2014;2014(Table 2):1–11.
- Abstract Viewed: 209 times
- PDF Downloaded: 140 times