Indian Journal of Obstetrics and Gynecology Research

Usefulness of PAPP-A in predicting adverse pregnancy outcome

Full Text PDF

Author Details: Madhumathi, Jaya Vijayaraghavan

Volume : 4

Issue : 2

Online ISSN : 2394-2754

Print ISSN : 2394-2746

Article First Page : 137

Article End Page : 140


Objective: The First trimester Pregnancy-associated plasma protein-A (PAPP-A) is one of the marker for the screening. The purpose of this study was to evaluate whether low levels of first trimester PAPP-A alone is predictive for adverse pregnancy outcomes such as intrauterine growth restriction, gestational hypertension, pre-eclampsia, low birth weight and preterm labour.
Study design: This study included patients with singleton pregnancies who underwent combined first trimester screening using nuchal translucency (NT) and maternal serum free beta-human chorionic gonadotrophin (free beta-hCG) and PAPP-A at 11-13+6weeks gestation. The incidence of various adverse pregnancy outcomes such as spontaneous preterm labor, fetal growth restriction (FGR), pre-eclampsia and gestational hypertension and low birth weight were correlated in relation to Abnormal PAPP-A values(<0.4MOM).
Results: In our study out of the 1100 patient were enrolled 167 women were lost to follow up and 9 were excluded.924 patients followed up for adverse pregnancy outcome. Abnormal PAPPA was found in 12.5%. IUGR was found in 10.5% (n=12;OR-5.1) preeclampsia in 8.8%(n=10;OR-2.7), Gestational hypertension 3.5% (n=4;OR-0.552), Preterm labour 15.8% (n=18;OR-2.6) and Low birth weight in 33.3% (n=38; P vlaue-0.001) women of which 25.4% delivered at term and only 7.9% delivered as preterm.
Conclusion: This study demonstrated that maternal serum PAPP-A is low in pregnancies resulting in Intrauterine growth restriction, Pre-eclampsia, Preterm labour and Low birth weight. However the sensitivity of Abnormal PAPP-A to predict adverse pregnancy outcomes is poor. Thus, PAPP-A is a good predictor for adverse pregnancy outcome mainly IUGR but hence cannot be used for screening test.

Intrauterine growth restriction, Pregnancy associated plasma protein A, Fetal Growth restriction, Growth factor binding protein, Multiples of median, Adverse pregnancy outcome

Doi No:-10.18231