First trimester pregnancy-associated plasma protein-A and birth weight

Rebecca J Baer; Deirdre J Lyell; Mary E Norton; Robert J Currier; Laura L Jelliffe-Pawlowski

doi:10.1016/j.ejogrb.2015.12.019

First trimester pregnancy-associated plasma protein-A and birth weight

Eur J Obstet Gynecol Reprod Biol. 2016 Mar:198:1-6. doi: 10.1016/j.ejogrb.2015.12.019. Epub 2015 Dec 30.

Authors

Rebecca J Baer¹, Deirdre J Lyell², Mary E Norton³, Robert J Currier⁴, Laura L Jelliffe-Pawlowski⁵

Affiliations

¹ Genetic Disease Screening Program, California Department of Public Health, 850 Marina Bay Parkway, Richmond, CA 94804, United States; Department of Pediatrics, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States. Electronic address: rebecca.baer@cdph.ca.gov.
² Stanford University, Department of Obstetrics & Gynecology, 300 Pasteur Drive, Stanford, CA 94305, United States. Electronic address: dlyell@stanford.edu.
³ Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, 505 Parnassus Ave, San Francisco, CA 94143, United States. Electronic address: nortonm@obgyn.ucsf.edu.
⁴ Genetic Disease Screening Program, California Department of Public Health, 850 Marina Bay Parkway, Richmond, CA 94804, United States. Electronic address: Bob.Currier@cdph.ca.gov.
⁵ Genetic Disease Screening Program, California Department of Public Health, 850 Marina Bay Parkway, Richmond, CA 94804, United States; Department of Epidemiology and Biostatistics, University of California School of Medicine, 550 16th Street, San Francisco, CA 94158, United States. Electronic address: Laura.Jelliffe@cdph.ca.gov.

PMID: 26773241
DOI: 10.1016/j.ejogrb.2015.12.019

Abstract

Objective: To evaluate first trimester pregnancy-associated plasma protein-A (PAPP-A) and birth weight percentile.

Study design: Included were women who underwent first trimester prenatal screening through the California Prenatal Screening Program with expected dates of delivery between August 2009 and December 2010, linked birth certificate and hospital discharge records, known birth weight, and no chromosomal abnormality (n=134.105). PAPP-A results were reported as multiples of the median. The frequency of small or large for gestational age (SGA, ≤10%; LGA, ≥90%) versus appropriately grown for gestational age birth was examined by PAPP-A percentile. Patterns were studied by gestational age at delivery. Relative risks (RRs) and their 95% confidence intervals were adjusted for race/ethnicity.

Results: Women with PAPP-A ≤10th percentile and an infant born after 32 weeks were increasingly more likely to have an SGA infant (adjRRs 1.5-4.6) as the PAPP-A percentile declined, and were increasingly less like to have an LGA infant born at term (adjRRs 0.5-0.7) compared to women with PAPP-A measurement >10th to <90th percentile. PAPP-A ≥90th percentile was protective for SGA among infants born after 32 weeks gestation (adjRRs 0.3-0.7) and was associated with LGA among infants born at term (adjRRs 1.2-8.2).

Conclusion: Women with PAPP-A ≤10th percentile are more likely to have an SGA infant at all gestational ages. PAPP-A ≥90th percentile is protective against SGA and is associated with an increased risk of LGA for infants born after 32 weeks gestation.

Keywords: Birth weight; Large for gestational age; PAPP-A; Preterm birth; Small for gestational age.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Birth Weight / physiology*
Female
Gestational Age
Humans
Infant, Newborn
Infant, Small for Gestational Age / blood*
Membrane Glycoproteins
Pregnancy
Pregnancy Trimester, First / blood*
Pregnancy-Associated Plasma Protein-A / metabolism*
Prenatal Diagnosis
Receptors, Interleukin-1

Substances

Membrane Glycoproteins
Receptors, Interleukin-1
TIRAP protein, human
Pregnancy-Associated Plasma Protein-A