First trimester serum PAPP-A is associated with placenta accreta: a retrospective study

Area of Science:

• Reproductive Medicine
• Maternal-Fetal Medicine
• Biochemistry

Background:

• Placenta accreta is a serious obstetric complication.
• Early identification of placenta accreta is crucial for improved maternal and fetal outcomes.
• Pregnancy-associated plasma protein-A (PAPP-A) is a biomarker used in prenatal screening.

Purpose of the Study:

• To investigate differences in first-trimester serum PAPP-A levels among pregnancies with placenta previa-accreta, non-adherent placenta previa, and healthy pregnancies.
• To determine if PAPP-A can serve as a predictor for placenta accreta.

Main Methods:

• Retrospective cohort analysis of 177 pregnant females.
• Included 35 placenta previa-accreta cases, 30 non-adherent placenta previa cases, and 112 healthy controls.
• Analyzed PAPP-A multiples of the median (MoM) and used logistic regression to identify predictors.

Main Results:

• PAPP-A MoM was significantly higher in the placenta previa-accreta group compared to both non-adherent placenta previa and control groups.
• Serum PAPP-A showed a significant positive association with placenta accreta after adjusting for confounding factors.
• Smoking and previous cesarean section history were also significantly associated with placenta accreta.

Conclusions:

• Elevated first-trimester serum PAPP-A is associated with placenta accreta.
• PAPP-A may play a role in identifying pregnancies at high risk for placenta accreta.
• Smoking and prior cesarean sections are potential risk factors for accreta in placenta previa patients.