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Association Between First-Trimester Serum PAPP-A and Free β-hCG Levels and Gestational Duration: A Retrospective
Gorkem Arica1, Dogu Kucuksuleymanoglu1, Ismail Yilmaz1
1Cerrahpasa Faculty of Medicine, Department of Obstetrics and Gynecology, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Irish Journal of Medical Science
|June 16, 2026
Summary
First-trimester PAPP-A MoM levels are linked to longer pregnancy duration. Higher levels indicate extended gestational length, independent of parity and fetal sex, suggesting early placental function influences parturition timing.
Area of Science:
- Reproductive Biology
- Maternal-Fetal Medicine
- Biomarker Research
Background:
- Gestational duration is multifactorial, with placental function being a key determinant.
- First-trimester serum biomarkers offer insights into placentation quality and potential pregnancy duration.
- Understanding these early markers can aid in predicting term completion.
Purpose of the Study:
- To examine the association between first-trimester placental biomarkers and gestational duration.
- To evaluate the independent impact of nulliparity and fetal sex on pregnancy length.
- To identify early predictors of gestational duration.
Main Methods:
- Retrospective study of 346 singleton pregnancies.
- Measurement of first-trimester PAPP-A and free β-hCG multiples of the median (MoM).
- Statistical analysis using Spearman correlation and multiple linear regression.
Main Results:
- Higher PAPP-A MoM (≥0.6) correlated with significantly longer gestational duration (273 vs. 269 days).
- PAPP-A MoM, nulliparity, and fetal sex were independent predictors of gestational duration.
- No significant association found between free β-hCG MoM and gestational duration.
Conclusions:
- Elevated first-trimester PAPP-A MoM is independently associated with longer gestational duration.
- Early placental function, indicated by PAPP-A, appears to modestly influence parturition timing.
- Parity and fetal sex also independently affect gestational length.
