Prediction of adverse pregnancy outcomes by extreme values of first trimester screening markers
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Updated: Feb 20, 2026

Semiconductor Sequencing for Preimplantation Genetic Testing for Aneuploidy
Published on: August 25, 2019
Marina S Gomes1, Mariana Carlos-Alves1, Vera Trocado1,2
1Department of Obstetrics and Gynecology, Alto Minho Local Healthcare Unit, Viana do Castelo, Portugal.
Background:
To determine the association between extreme values of first trimester markers and adverse pregnancy outcomes.
Methods:
A retrospective cohort study of 916 women who underwent first-trimester combined screening during 2015 was performed. Extreme values of NT, pregnancy-associated plasma protein-A (PAPP-A) and free β-hCG, and their association with adverse pregnancy outcomes were analyzed.
Results:
Low PAPP-A (<10th percentile) was associated with an increased risk for preeclampsia (adjusted odds ratio (AOR) 4.13), fetal growth restriction (AOR 3.94) and abruptio placentae (AOR 52.63). Abnormally low or high free β-hCG, high PAPP-A or increased NT was not associated with an increased risk for adverse outcomes.
Discussion:
PAPP-A <10th percentile could be associated with an increased risk for adverse outcomes. However, the majority of patients with these events do not have abnormal PAPP-A and few patients with PAPP-A <10th percentile will have an adverse outcome.
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