Predictive value of pregnancy-associated plasma protein-A (PAPP-A) and free beta-hCG on fetal growth restriction: results of a prospective study
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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
Pregnancy-associated plasma protein-A Free-beta human chorionic gonadotropin Intra-uterine growth restriction Fetal aneuploidy Birth weight Preterm laborNotes
Acknowledgments
The present article has been realized also thanks to the important scientific collaboration with Dr Francesca Romana Giorlandino (Department of Biochemistry - Altamedica Main Center - Rome - Italy) and Dr Diana Giannarelli (Department of Statistics - National Cancer Institute "Regina Elena" - Rome - Italy).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
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