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. 2019 Oct;69(5):412-419.
doi: 10.1007/s13224-019-01217-3. Epub 2019 Apr 11.

The Relationship of Pregnancy-Associated Plasma Protein A and Human Chorionic Gonadotropin with Adverse Pregnancy Outcomes: A Prospective Study

Hamideh Pakniat  1 , Atieh Bahman  2 , Iman Ansari  3
Affiliations

The Relationship of Pregnancy-Associated Plasma Protein A and Human Chorionic Gonadotropin with Adverse Pregnancy Outcomes: A Prospective Study

Hamideh Pakniat et al. J Obstet Gynaecol India. 2019 Oct.

Abstract

Purpose: This prospective study investigated the relationship between pregnancy-associated plasma protein A (PAPP-A) and human chorionic gonadotropin (hCG) and adverse pregnancy outcomes in the Iranian population.

Materials: Overall, 994 singleton pregnant mothers of 18-35-year old were referred for first-trimester screening tests, including PAPP-A and β-hCG, at the age of 6 days and 11-13 weeks, and were followed until the end of their pregnancy. The adverse pregnancy outcomes, PAPP-A, and β-hCG serum levels were recorded and analyzed. The sensitivity and specificity of the test were measured by calculating the area under the curve of receiver operating characteristic curve (ROC).

Results: The mean serum level of PAPP-A and β-hCG was 1.10 ± 0.69 and 1.09 ± 0.8 MoM, respectively. Pregnancy-associated plasma protein A, regardless of its percentile, showed a significant relationship with the incidence of preeclampsia, preterm birth, and fetal low birth weight (p < 0.001 for each). However, the relationship between PAPP-A and abortion was not significant (p > 0.05). According to ROC, the results indicated that PAPP-A had a significant relationship with the incidence of preeclampsia, preterm birth, and fetal low birth weight (p < 0.001). However, β-hCG levels showed no significant relationship with adverse pregnancy outcomes.

Conclusions: The result of this study revealed that lower level of PAPP-A and β-hCG could be a predictive factor in preterm labor. Also, this study indicated that PAPP-A measurements could be a screening test for adverse pregnancy outcomes, such as preeclampsia, low birth weight and preterm labor.

Keywords: Abortion; Low birth weight; PAPP-A; Preeclampsia; Preterm labor; β-hCG.

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Conflict of interest statement

Conflict of interestThe authors declared no conflict of interest.

Figures

Fig. 1
Fig. 1
Diagnostic value of PAPP-A for detecting of preeclampsia according to ROC
Fig. 2
Fig. 2
Diagnostic value of PAPP-A for detecting preterm labor according to ROC
Fig. 3
Fig. 3
Diagnostic value of PAPP-A for detecting low birth weight according to ROC
See this image and copyright information in PMC

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