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Relationship Between PAPP-A Levels in the First Trimester of Pregnancy and Complication Risk.

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First-trimester pregnancy-associated plasma protein A (PAPP-A) is a key marker for pregnancy complications. Low PAPP-A levels significantly increase the risk of hypertensive disorders, fetal growth restriction, preterm birth, and miscarriage.

Keywords:
fetal growth restrictionhypertensive disorders in pregnancymiscarriagepregnancy complicationpregnancy-associated plasma protein Apreterm birth

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Area of Science:

  • Biochemistry
  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine

Background:

  • Pregnancy-associated plasma protein A (PAPP-A) is a protein produced during pregnancy.
  • It is increasingly recognized as a potential biomarker for identifying high-risk pregnancies.
  • Early identification of pregnancy complications is crucial for timely intervention.

Purpose of the Study:

  • To investigate the association between first-trimester PAPP-A levels and the risk of adverse pregnancy outcomes.
  • To determine if low PAPP-A levels can predict specific pregnancy complications.

Main Methods:

  • A prospective cohort study involving 606 pregnant women was conducted.
  • First-trimester PAPP-A levels were measured using the double test.
  • Statistical analyses, including odds ratios and multivariate regression, were used to assess associations with complications like hypertensive disorders, fetal growth restriction, preterm birth, miscarriage, and stillbirth.

Main Results:

  • 14.2% of participants had low PAPP-A levels (< 0.5 MoM).
  • Low PAPP-A levels were significantly associated with increased risks of hypertensive disorders (OR: 5.1), fetal growth restriction (OR: 2.54), spontaneous preterm birth (OR: 7.48), and miscarriage (OR: 4.5).
  • Multivariate analysis confirmed these independent associations.

Conclusions:

  • Low first-trimester PAPP-A levels are a significant predictor of several pregnancy complications.
  • PAPP-A may serve as a valuable screening tool for identifying pregnancies at risk.
  • Further research integrating PAPP-A with other markers is recommended for improved predictive models.