Maternal serum PAPP-A as an early marker of obstetric complications?

ABSTRACT

OBJECTIVE: The aim of this study was to investigate whether low first-trimester PAPP-A levels are associated with an adverse pregnancy outcome. MATERIALS AND METHODS: A retrospective case-control study was carried out using a Down's syndrome assays database over a 6-year period, between the 8th and 11th week of pregnancy. There were 164 women with PAPP-A multiples of median (MoM) levels <0.3 and 1,640 women with PAPP-A MoM levels ≥0.3 who served as a control group. Outcome measures were the prevalence of miscarriages, gestational hypertension, preeclampsia, pre-term delivery, gestational diabetes and intrauterine growth retardation in both groups. RESULTS: The two groups significantly differed only for miscarriages 29 (17.7%) vs. 159 (9.7%), p = 0.04, OR 1.7; gestational hypertension 15 (9.1%) vs. 74 (4.5%), p = 0.02, OR 2.1, and preeclampsia 9 (5.5%) vs. 29 (1.8%), p = 0.02, OR 2.5. DISCUSSION: Even if in this study the PAPP-A cutoff considered was lower and was assayed in an earlier period compared with other studies, the detection rate for adverse pregnancy outcomes did not improve.