The risk of adverse pregnancy outcome among pregnancies with extremely low maternal PAPP-A.

Abstract:

OBJECTIVE:The aim of the study was to analyze the risk of adverse pregnancy outcome in three subgroups with extremely low maternal pregnancy-associated plasma protein-A (PAPP-A), that is, <0.3 multiples of median (MoM) at the first trimester screening. METHOD:A cohort of 961 pregnancies with PAPP-A levels < 0.3 MoM at the first trimester combined screening was followed up during the study period of January 2009 to December 2012. The incidences of adverse outcomes was determined in three subgroups with PAPP-A levels < 0.1 MoM, 0.1 to 0.2 MoM, and 0.2 to 0.3 MoM, respectively. RESULTS:The risks of aneuploidy and spontaneous abortion increased with decreasing PAPP-A levels (p < 0.001), but no difference was detected in the rate of structural anomalies among the three groups. Rates of preterm delivery (p < 0.001) and birth weight < 2 standard deviation below the mean (p < 0.001) increased with decreasing PAPP-A levels. The rates of preeclampsia, stillbirth, and cesarean delivery were not significantly different across the three subgroups. CONCLUSION:The risks of aneuploidy, spontaneous abortion, preterm delivery, and small for gestational age newborn increased with decreasing PAPP-A. © 2016 John Wiley & Sons, Ltd.

journal_name

Prenat Diagn

journal_title

Prenatal diagnosis

authors

Kaijomaa M,Ulander VM,Hämäläinen E,Alfthan H,Markkanen H,Heinonen S,Stefanovic V

doi

10.1002/pd.4946

subject

Has Abstract

pub_date

2016-12-01 00:00:00

pages

1115-1120

issue

12

eissn

0197-3851

issn

1097-0223

journal_volume

36

pub_type

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