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Review
. 2021 Mar;303(3):645-652.
doi: 10.1007/s00404-020-05960-1. Epub 2021 Jan 30.

First trimester serum PAPP-A is associated with placenta accreta: a retrospective study

Fengge Wang #  1   2 , Shuxiong Chen #  1   3 , Jishui Wang  1   2 , Yangping Wang  1   2 , Fang Ruan  1   2 , Hua Shu  1   2 , Liangxi Zhu  4   5 , Dongmei Man  6   7
Affiliations
Review

First trimester serum PAPP-A is associated with placenta accreta: a retrospective study

Fengge Wang et al. Arch Gynecol Obstet. 2021 Mar.

Abstract

Purpose: Our objective of this study was to investigate whether first trimester serum pregnancy-associated plasma protein-A (PAPP-A) differed amongst pregnancies with placenta previa-accreta and non-adherent placenta previa and healthy pregnancies by a retrospective cohort analysis.

Methods: A total of 177 pregnant females were included in the study, as follows: 35 cases of placenta previa-accreta, 30 cases of non-adherent placenta previa, and 112 cases of BMI and age matched, healthy pregnant controls. PAPP-A multiples of the median (MoM) were acquired from laboratory data files in 1 January 2017-30 September 2019. The probable maternal serum biochemical predictor of placenta accreta was analyzed by using multiple logistic regression analysis.

Results: PAPP-A MoM of placenta previa-accreta group was significantly higher than those of the non-adherent placenta previa group and control group (p = 0.009 < 0.05, p < 0.001). Serum PAPP-A was found to be significantly positively associated with placenta accreta after adjusted gestational week at time of blood sampling, BMI, age, smoking, and previous cesarean section history (OR: 3.51; 95% CI: 1.77-6.94; p = 0.0003 < 0.05). In addition, smoking (OR: 9.17; 95% CI: 1.69-49.62; p = 0.010 < 0.05) and previous cesarean section history (OR: 2.75; 95% CI: 1.23-6.17; p = 0.014 < 0.05) were also significantly associated with placenta accreta.

Conclusion: Increased first trimester serum PAPP-A was significantly positively associated with placenta accreta, suggesting that the potential role of PAPP-A in identifying pregnancies at high risk for placenta accreta. Smoking and previous cesarean section history may be the risk factors for accreta in placenta previa patients.

Keywords: Association; First trimester serum; PAPP-A; Placenta accreta.

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