Correlation of PAPP-A values with maternal characteristics, biochemical and ultrasonographic markers of pregrancy
Objective: Our aim is to investigate whether there is a correlation of pregnancy-associated plasma protein A (PAPP-A) values with other variables in pregnancy and maternal characteristics. Materials and Methods: We retrospectively analyzed the relation between the pregnancy-associated plasma protein A levels, demographics, biochemical and ultrasonographic markers of the first trimester screening of 11,842 pregnant women seen at a tertiary hospital between November 2002 and November 2008. Results: A significant difference between PAPP-A values of the diabetic and non-diabetic pregnant women were observed (p=0.0005, Mann-Whitney U test). In terms of weight, crown-rump length, BetahCG values, significant differences were observed between low and medium level PAPP-A subgroups and between low and high level PAPP-A subgroups. PAPP-A levels were found to differ significantly between the pregnant women of Caucasian origin and other racial origins. Conclusions: Pregnant women with different ethnic and medical backgrounds have different PAPP-A values and other markers of the aneupleudity screening. To make patient specific risk predictions, understanding these interactions and differences is important. Future studies are needed to understand the pathopyhsiology behind these differences.
___
- Smith GC, Stenhouse EJ, Crossley JA, Aitken DA, Cameron
AD, Connor JM. Early pregnancy levels of pregnancyassociated
plasma protein a and the risk of intrauterine growth
restriction, premature birth, preeclampsia, and stillbirth.
J Clin Endocrinol Metab 2002;87:1762-7. doi: 10.1210/
jcem.87.4.8430.
- Yaron Y, Heifetz S, Ochshorn Y, Lehavi O, Orr-Urtreger A.
Decreased first trimester PAPP-A is a predictor of adverse
pregnancy outcome. Prenat Diagn 2002;22:778-82. doi:
10.1002/pd.407.
- Hanita O, Roslina O, Azlin MI. Maternal level of pregnancyassociated
plasma protein A as a predictor of pregnancy failure
in threatened abortion. Malays J Pathol 2012;34:145-51.
- Cuckle H, Arbuzova S, Spencer K, et al. Frequency and clinical
consequences of extremely high maternal serum PAPP-A
levels. Prenat Diagn 2003;23:385-8. doi: 10.1002/pd.600.
- Westergaard JG, Teisner B, Grudzinskas JG. Serum PAPP-A
in normal pregnancy: relationship to fetal and maternal
characteristics. Arch Gynecol 1983;233:211-5. doi: 10.1007/
BF02114602.
- Wright D, Silva M, Papadopoulos S, Wright A, Nicolaides KH.
Serum pregnancy-associated plasma protein-A in the three
trimesters of pregnancy: effects of maternal characteristics
and medical history. Ultrasound Obstet Gynecol 2015;46:42-
50. doi: 10.1002/uog.14870.
- Browne JL, Klipstein-Grobusch K, Koster MP, et al. Pregnancy
associated plasma protein-a and placental growth factor in a
Sub-Saharan African population: A nested cross-sectional
study. PLoS ONE 2016;11:e0159592. doi: 10.1371/journal.
pone.0159592.
- Donovan BM, Nidey NL, Jasper EA, et al. First trimester
prenatal screening biomarkers and gestational diabetes
mellitus: A systematic review and meta-analysis. PLoS ONE
2018;13: e0201319. doi.org/10.1371/journal.pone.0201319
- Syngelaki A, Kotecha R, Pastides A, Wright A, Nicolaides
KH. First-trimester biochemical markers of placentation
in screening for gestational diabetes mellitus. Metabolism
2015;64:1485-9. doi: 10.1016/j.metabol.2015.07.015.
- DiPrisco B, Kumar A, Kalra B, et al. Placental proteases PAPP-A
and PAPP-A2, the binding proteins they cleave (IGFBP-4 and
– 5), and IGF-I and IGF-II: Levels in umbilical cord blood
and associations with birth weight and length. Metabolism
2019;100:153959. doi: 10.1016/j.metabol.2019.153959.
- Lovati E, Beneventi F, Simonetta M, et al. Gestational diabetes
mellitus: Including serum pregnancy-associated plasma
protein-A testing in the clinical management of primiparous
women? A case-control study. Diabetes Res Clin Pract
2013;100:340-7. doi: 10.1016/j.diabres.2013.04.002
- Grewal J, Grantz KL, Zhang C, et al. Cohort profile: NICHD
fetal growth studies-singletons and twins. Int J Epidemiol
2018;47:25-25l. doi:10.1093/ije/dyx161
- Villar J, Papageorghiou AT, Pang R, et al. The likeness of fetal
growth and newborn size across non-isolated populations
in the INTERGROWTH-21st Project: the Fetal Growth
Longitudinal Study and Newborn Cross-Sectional Study.
Lancet Diabetes Endocrinol 2014;2:781-92. doi:10.1016/
S2213-8587(14)70121-4
- Kiserud T, Piaggio G, Carroli G, et al. The World Health
Organization Fetal Growth Charts: A Multinational
Longitudinal Study of Ultrasound Biometric Measurements
and Estimated Fetal Weight [published correction appears
in PLoS Med 2017;14 (3):e1002284] [published correction
appears in PLoS Med 2017;14 (4):e1002301]. PLoS Med
2017;14(1):e1002220. Published 2017 Jan 24. doi:10.1371/
journal.pmed.1002220
- Bogin B, Varela-Silva MI. Leg length, body proportion, and
health: a review with a note on beauty. Int J Environ Res Public
Health 2010;7:1047-75. doi:10.3390/ijerph7031047
- Clausson B, Lichtenstein P, Cnattingius S. Genetic influence
on birthweight and gestational length determined by
studies in offspring of twins. BJOG 2000;107:375-81.
doi:10.1111/j.1471-0528.2000.tb13234.x.
- Lunde A, Melve KK, Gjessing HK, Skjaerven R, Irgens LM.
Genetic and environmental influences on birth weight, birth
length, head circumference, and gestational age by use of
population-based parent-offspring data. Am J Epidemiol
2007;165:734-41. doi:10.1093/aje/kwk107
- Grantz KL, Hediger ML, Liu D, Buck Louis GM. Fetal growth
standards: the NICHD fetal growth study approach in
context with INTERGROWTH-21st and the World Health
Organization Multicentre Growth Reference Study. Am J
Obstet Gynecol 2018;218(2S):S641-S655.e28. doi:10.1016/j.
ajog.2017.11.593