Association between first-trimester maternal serum pregnancy-associated plasma protein-A and obstetric complications
ABSTRACT Objective This study aimed to investigate the relationship between maternal serum pregnancy‐associated plasma protein‐A (PAPP‐A) in the first trimester of pregnancy and the development of preeclampsia (PE), early PE, small‐for‐gestational age (SGA) fetus and preterm delivery (PD). Method Th...
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| Veröffentlicht in: | Prenatal diagnosis 2013-09, Vol.33 (9), p.839-847 |
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| creator | D'Antonio, Francesco Rijo, Claudia Thilaganathan, Basky Akolekar, Ranjit Khalil, Asma Papageourgiou, Aris Bhide, Amar |
| description | ABSTRACT
Objective
This study aimed to investigate the relationship between maternal serum pregnancy‐associated plasma protein‐A (PAPP‐A) in the first trimester of pregnancy and the development of preeclampsia (PE), early PE, small‐for‐gestational age (SGA) fetus and preterm delivery (PD).
Method
This is a retrospective study of 12 355 pregnant women that delivered between 2008 and 2011. We define the first, third and fifth percentiles of maternal serum PAPP‐A multiples of the median (MoM). The primary outcome measures were the occurrence of PE, early PE (PE requiring delivery before 34 weeks), SGA fetus (birth weight |
| doi_str_mv | 10.1002/pd.4141 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1429638552</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3060168421</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3831-ad9cc752d59423054cad3c657409eb8c2bb07252d684f00a6ce32ca6955aa4a23</originalsourceid><addsrcrecordid>eNp1kdtKHEEQhpsQiauGvEFoyEWEMNrnmblcTKKBxQMoXjY1PbWhdU7pnsHs29ub2XgheFNdUF_91fUXIZ84O-GMidOhPlFc8XdkwVmZZ0wI-Z4sGE-5LDTfJwcxPiSwEGX-gewLabgUhi_IuIyxdx5G33e0wvEJsaNrH-KYjcG3GEcMtIUUO2hoxDC1dAj4u4PObTLYNWNNhwZiC6nWj-i7bEmhq2lfpf6k46jr26Hx7t-ceET21tBE_Lh7D8ndzx-3ZxfZ6ur819lylTlZSJ5BXTqXa1HrUgnJtHJQS2d0rliJVeFEVbFcpLop1JoxMA6lcGBKrQEUCHlIjmfd9Ks_U9rFtj46bBrosJ-i5UqUJvmjt-iXV-hDP213nimuCmlkor7OlAt9jAHXdkgmQdhYzuz2EHao7fYQify805uqFusX7r_zCfg2A0--wc1bOvb6-04um2mfDP37QkN4tCaXubb3l-f29np1Y3JzYUv5DA_voPY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1429148363</pqid></control><display><type>article</type><title>Association between first-trimester maternal serum pregnancy-associated plasma protein-A and obstetric complications</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>D'Antonio, Francesco ; Rijo, Claudia ; Thilaganathan, Basky ; Akolekar, Ranjit ; Khalil, Asma ; Papageourgiou, Aris ; Bhide, Amar</creator><creatorcontrib>D'Antonio, Francesco ; Rijo, Claudia ; Thilaganathan, Basky ; Akolekar, Ranjit ; Khalil, Asma ; Papageourgiou, Aris ; Bhide, Amar</creatorcontrib><description>ABSTRACT
Objective
This study aimed to investigate the relationship between maternal serum pregnancy‐associated plasma protein‐A (PAPP‐A) in the first trimester of pregnancy and the development of preeclampsia (PE), early PE, small‐for‐gestational age (SGA) fetus and preterm delivery (PD).
Method
This is a retrospective study of 12 355 pregnant women that delivered between 2008 and 2011. We define the first, third and fifth percentiles of maternal serum PAPP‐A multiples of the median (MoM). The primary outcome measures were the occurrence of PE, early PE (PE requiring delivery before 34 weeks), SGA fetus (birth weight < 5th centile) and PD. The Mann–Whitney U‐test and chi‐squared test were used to analyze continuous and dichotomous variables, respectively.
Results
Maternal serum PAPP‐A was significantly lower in women with PE, early PE, SGA fetus and PD (0.91, 0.74, 0.80 and 0.84 MoM, respectively) than in the study population (0.99 MoM) (p < 0.05). The lower the MoM percentile of PAPP‐A, the higher are the odds ratio (OR) to develop PE, early PE, SGA fetus and PD.
Conclusions
Maternal serum PAPP‐A levels are lower in women who develop preeclampsia, those with SGA fetus and those who deliver preterm. However, on its own, maternal serum PAPP‐A performs poorly (OR for PE between 1.76 and 2.41 with the lower percentile of PAPP‐A) as a screening test for these conditions. © 2013 John Wiley & Sons, Ltd.
What's already known about this topic?
Low first‐trimester pregnancy‐associated placental protein‐A (PAPP‐A) is linked with many pregnancy complications such as preeclampsia, SGA fetus and preterm birth.
What does this study add?
Apart from adding data of several thousand women, this study quantifies the extent of the increase in the risk for these complications by a review of the published literature. This information will be useful to inform mothers with low first‐trimester levels of serum PAPP‐A.</description><identifier>ISSN: 0197-3851</identifier><identifier>EISSN: 1097-0223</identifier><identifier>DOI: 10.1002/pd.4141</identifier><identifier>PMID: 23613261</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adult ; Female ; Fetal Death - blood ; Fetal Death - epidemiology ; Fetal Growth Retardation - blood ; Fetal Growth Retardation - diagnosis ; Fetal Growth Retardation - epidemiology ; Humans ; Infant, Newborn ; Infant, Small for Gestational Age ; Pre-Eclampsia - blood ; Pre-Eclampsia - diagnosis ; Pre-Eclampsia - epidemiology ; Pregnancy ; Pregnancy Complications - blood ; Pregnancy Complications - diagnosis ; Pregnancy Trimester, First - blood ; Pregnancy-Associated Plasma Protein-A - analysis ; Premature Birth - blood ; Premature Birth - diagnosis ; Premature Birth - epidemiology ; Retrospective Studies</subject><ispartof>Prenatal diagnosis, 2013-09, Vol.33 (9), p.839-847</ispartof><rights>2013 John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3831-ad9cc752d59423054cad3c657409eb8c2bb07252d684f00a6ce32ca6955aa4a23</citedby><cites>FETCH-LOGICAL-c3831-ad9cc752d59423054cad3c657409eb8c2bb07252d684f00a6ce32ca6955aa4a23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fpd.4141$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fpd.4141$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27929,27930,45579,45580</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23613261$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>D'Antonio, Francesco</creatorcontrib><creatorcontrib>Rijo, Claudia</creatorcontrib><creatorcontrib>Thilaganathan, Basky</creatorcontrib><creatorcontrib>Akolekar, Ranjit</creatorcontrib><creatorcontrib>Khalil, Asma</creatorcontrib><creatorcontrib>Papageourgiou, Aris</creatorcontrib><creatorcontrib>Bhide, Amar</creatorcontrib><title>Association between first-trimester maternal serum pregnancy-associated plasma protein-A and obstetric complications</title><title>Prenatal diagnosis</title><addtitle>Prenat Diagn</addtitle><description>ABSTRACT
Objective
This study aimed to investigate the relationship between maternal serum pregnancy‐associated plasma protein‐A (PAPP‐A) in the first trimester of pregnancy and the development of preeclampsia (PE), early PE, small‐for‐gestational age (SGA) fetus and preterm delivery (PD).
Method
This is a retrospective study of 12 355 pregnant women that delivered between 2008 and 2011. We define the first, third and fifth percentiles of maternal serum PAPP‐A multiples of the median (MoM). The primary outcome measures were the occurrence of PE, early PE (PE requiring delivery before 34 weeks), SGA fetus (birth weight < 5th centile) and PD. The Mann–Whitney U‐test and chi‐squared test were used to analyze continuous and dichotomous variables, respectively.
Results
Maternal serum PAPP‐A was significantly lower in women with PE, early PE, SGA fetus and PD (0.91, 0.74, 0.80 and 0.84 MoM, respectively) than in the study population (0.99 MoM) (p < 0.05). The lower the MoM percentile of PAPP‐A, the higher are the odds ratio (OR) to develop PE, early PE, SGA fetus and PD.
Conclusions
Maternal serum PAPP‐A levels are lower in women who develop preeclampsia, those with SGA fetus and those who deliver preterm. However, on its own, maternal serum PAPP‐A performs poorly (OR for PE between 1.76 and 2.41 with the lower percentile of PAPP‐A) as a screening test for these conditions. © 2013 John Wiley & Sons, Ltd.
What's already known about this topic?
Low first‐trimester pregnancy‐associated placental protein‐A (PAPP‐A) is linked with many pregnancy complications such as preeclampsia, SGA fetus and preterm birth.
What does this study add?
Apart from adding data of several thousand women, this study quantifies the extent of the increase in the risk for these complications by a review of the published literature. This information will be useful to inform mothers with low first‐trimester levels of serum PAPP‐A.</description><subject>Adult</subject><subject>Female</subject><subject>Fetal Death - blood</subject><subject>Fetal Death - epidemiology</subject><subject>Fetal Growth Retardation - blood</subject><subject>Fetal Growth Retardation - diagnosis</subject><subject>Fetal Growth Retardation - epidemiology</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Infant, Small for Gestational Age</subject><subject>Pre-Eclampsia - blood</subject><subject>Pre-Eclampsia - diagnosis</subject><subject>Pre-Eclampsia - epidemiology</subject><subject>Pregnancy</subject><subject>Pregnancy Complications - blood</subject><subject>Pregnancy Complications - diagnosis</subject><subject>Pregnancy Trimester, First - blood</subject><subject>Pregnancy-Associated Plasma Protein-A - analysis</subject><subject>Premature Birth - blood</subject><subject>Premature Birth - diagnosis</subject><subject>Premature Birth - epidemiology</subject><subject>Retrospective Studies</subject><issn>0197-3851</issn><issn>1097-0223</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kdtKHEEQhpsQiauGvEFoyEWEMNrnmblcTKKBxQMoXjY1PbWhdU7pnsHs29ub2XgheFNdUF_91fUXIZ84O-GMidOhPlFc8XdkwVmZZ0wI-Z4sGE-5LDTfJwcxPiSwEGX-gewLabgUhi_IuIyxdx5G33e0wvEJsaNrH-KYjcG3GEcMtIUUO2hoxDC1dAj4u4PObTLYNWNNhwZiC6nWj-i7bEmhq2lfpf6k46jr26Hx7t-ceET21tBE_Lh7D8ndzx-3ZxfZ6ur819lylTlZSJ5BXTqXa1HrUgnJtHJQS2d0rliJVeFEVbFcpLop1JoxMA6lcGBKrQEUCHlIjmfd9Ks_U9rFtj46bBrosJ-i5UqUJvmjt-iXV-hDP213nimuCmlkor7OlAt9jAHXdkgmQdhYzuz2EHao7fYQify805uqFusX7r_zCfg2A0--wc1bOvb6-04um2mfDP37QkN4tCaXubb3l-f29np1Y3JzYUv5DA_voPY</recordid><startdate>201309</startdate><enddate>201309</enddate><creator>D'Antonio, Francesco</creator><creator>Rijo, Claudia</creator><creator>Thilaganathan, Basky</creator><creator>Akolekar, Ranjit</creator><creator>Khalil, Asma</creator><creator>Papageourgiou, Aris</creator><creator>Bhide, Amar</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T5</scope><scope>7T7</scope><scope>7TK</scope><scope>7TM</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>201309</creationdate><title>Association between first-trimester maternal serum pregnancy-associated plasma protein-A and obstetric complications</title><author>D'Antonio, Francesco ; Rijo, Claudia ; Thilaganathan, Basky ; Akolekar, Ranjit ; Khalil, Asma ; Papageourgiou, Aris ; Bhide, Amar</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3831-ad9cc752d59423054cad3c657409eb8c2bb07252d684f00a6ce32ca6955aa4a23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Female</topic><topic>Fetal Death - blood</topic><topic>Fetal Death - epidemiology</topic><topic>Fetal Growth Retardation - blood</topic><topic>Fetal Growth Retardation - diagnosis</topic><topic>Fetal Growth Retardation - epidemiology</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Infant, Small for Gestational Age</topic><topic>Pre-Eclampsia - blood</topic><topic>Pre-Eclampsia - diagnosis</topic><topic>Pre-Eclampsia - epidemiology</topic><topic>Pregnancy</topic><topic>Pregnancy Complications - blood</topic><topic>Pregnancy Complications - diagnosis</topic><topic>Pregnancy Trimester, First - blood</topic><topic>Pregnancy-Associated Plasma Protein-A - analysis</topic><topic>Premature Birth - blood</topic><topic>Premature Birth - diagnosis</topic><topic>Premature Birth - epidemiology</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>D'Antonio, Francesco</creatorcontrib><creatorcontrib>Rijo, Claudia</creatorcontrib><creatorcontrib>Thilaganathan, Basky</creatorcontrib><creatorcontrib>Akolekar, Ranjit</creatorcontrib><creatorcontrib>Khalil, Asma</creatorcontrib><creatorcontrib>Papageourgiou, Aris</creatorcontrib><creatorcontrib>Bhide, Amar</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Neurosciences Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Prenatal diagnosis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>D'Antonio, Francesco</au><au>Rijo, Claudia</au><au>Thilaganathan, Basky</au><au>Akolekar, Ranjit</au><au>Khalil, Asma</au><au>Papageourgiou, Aris</au><au>Bhide, Amar</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association between first-trimester maternal serum pregnancy-associated plasma protein-A and obstetric complications</atitle><jtitle>Prenatal diagnosis</jtitle><addtitle>Prenat Diagn</addtitle><date>2013-09</date><risdate>2013</risdate><volume>33</volume><issue>9</issue><spage>839</spage><epage>847</epage><pages>839-847</pages><issn>0197-3851</issn><eissn>1097-0223</eissn><abstract>ABSTRACT
Objective
This study aimed to investigate the relationship between maternal serum pregnancy‐associated plasma protein‐A (PAPP‐A) in the first trimester of pregnancy and the development of preeclampsia (PE), early PE, small‐for‐gestational age (SGA) fetus and preterm delivery (PD).
Method
This is a retrospective study of 12 355 pregnant women that delivered between 2008 and 2011. We define the first, third and fifth percentiles of maternal serum PAPP‐A multiples of the median (MoM). The primary outcome measures were the occurrence of PE, early PE (PE requiring delivery before 34 weeks), SGA fetus (birth weight < 5th centile) and PD. The Mann–Whitney U‐test and chi‐squared test were used to analyze continuous and dichotomous variables, respectively.
Results
Maternal serum PAPP‐A was significantly lower in women with PE, early PE, SGA fetus and PD (0.91, 0.74, 0.80 and 0.84 MoM, respectively) than in the study population (0.99 MoM) (p < 0.05). The lower the MoM percentile of PAPP‐A, the higher are the odds ratio (OR) to develop PE, early PE, SGA fetus and PD.
Conclusions
Maternal serum PAPP‐A levels are lower in women who develop preeclampsia, those with SGA fetus and those who deliver preterm. However, on its own, maternal serum PAPP‐A performs poorly (OR for PE between 1.76 and 2.41 with the lower percentile of PAPP‐A) as a screening test for these conditions. © 2013 John Wiley & Sons, Ltd.
What's already known about this topic?
Low first‐trimester pregnancy‐associated placental protein‐A (PAPP‐A) is linked with many pregnancy complications such as preeclampsia, SGA fetus and preterm birth.
What does this study add?
Apart from adding data of several thousand women, this study quantifies the extent of the increase in the risk for these complications by a review of the published literature. This information will be useful to inform mothers with low first‐trimester levels of serum PAPP‐A.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>23613261</pmid><doi>10.1002/pd.4141</doi><tpages>9</tpages></addata></record> |
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| identifier | ISSN: 0197-3851 |
| ispartof | Prenatal diagnosis, 2013-09, Vol.33 (9), p.839-847 |
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| source | MEDLINE; Access via Wiley Online Library |
| subjects | Adult Female Fetal Death - blood Fetal Death - epidemiology Fetal Growth Retardation - blood Fetal Growth Retardation - diagnosis Fetal Growth Retardation - epidemiology Humans Infant, Newborn Infant, Small for Gestational Age Pre-Eclampsia - blood Pre-Eclampsia - diagnosis Pre-Eclampsia - epidemiology Pregnancy Pregnancy Complications - blood Pregnancy Complications - diagnosis Pregnancy Trimester, First - blood Pregnancy-Associated Plasma Protein-A - analysis Premature Birth - blood Premature Birth - diagnosis Premature Birth - epidemiology Retrospective Studies |
| title | Association between first-trimester maternal serum pregnancy-associated plasma protein-A and obstetric complications |
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