Predictive value of pregnancy-associated plasma protein-A (PAPP-A) and free beta-hCG on fetal growth restriction: results of a prospective study

Arch Gynecol Obstet. 2016 Jun;293(6):1227-33. doi: 10.1007/s00404-015-3947-z. Epub 2015 Nov 11.

Abstract

Purpose: Low levels of plasmatic pregnancy-associated plasma protein-A (PAPP-A) and high levels of free-beta human chorionic gonadotropin (beta-hCG) could influence the outcome of pregnancy. The objective of this study is to assess the correlation between PAPP-A and free beta-hCG and birth weight.

Materials and methods: Prospective follow-up study performed on 3332 patients in the first trimester of pregnancy who were subjected to a screening test focused on evaluation of fetal aneuploidy (SCA-TEST). The values of PAPP-A and free beta-hCG were both analyzed as raw values and subsequently converted to a multiple of the median (MoM). Statistical analysis was performed using SPSS version 17.0.1 (SPSS Inc., Chicago, USA).

Results: The incidence of "small for gestational age" in patients with PAPP-A MoM <1st and <5th ‰ was statistically significant (12 and 9.8 %; p < 0.0001). Also statistically significant data have been highlighted about free beta MoM > 95th ‰ (7 %; p = 0.03). The values of PAPP-A MoM > 99th ‰ are significantly correlated with an increased risk of "large for gestational age" (16.7 %; p < 0.0001).

Conclusion: Our study demonstrates that specific values of PAPP-A and free beta-hCG could identify the risk of low or high birth weight since the first trimester of pregnancy.

Keywords: Birth weight; Fetal aneuploidy; Free-beta human chorionic gonadotropin; Intra-uterine growth restriction; Pregnancy-associated plasma protein-A; Preterm labor.

MeSH terms

  • Adult
  • Aneuploidy
  • Biomarkers / blood
  • Birth Weight*
  • Chorionic Gonadotropin, beta Subunit, Human / blood*
  • Female
  • Fetal Growth Retardation / blood*
  • Follow-Up Studies
  • Gestational Age
  • Humans
  • Infant, Small for Gestational Age / blood
  • Pregnancy
  • Pregnancy Trimester, First / blood
  • Pregnancy-Associated Plasma Protein-A / analysis*
  • Prospective Studies

Substances

  • Biomarkers
  • Chorionic Gonadotropin, beta Subunit, Human
  • Pregnancy-Associated Plasma Protein-A