Low pregnancy-associated plasma protein-a at 10(+1) to 14(+6) weeks of gestation and a possible mechanism leading to miscarriage.
OBJECTIVE
To compare pregnancy-associated plasma protein-A (PAPP-A) serum levels at 10(+1) to 14(+6) weeks gestation in groups of patients with different obstetrical outcomes.


METHODS
The medical records of women who had consented to donate blood for biochemical research purposes while their pregnancies were uncomplicated were reviewed to define the clinical groups. After the clinical groups were defined, the donated maternal serum samples were thawed and PAPP-A measured by ELISA. ANOVA was used to compare mean values within groups.


RESULTS
All groups had similar gestational ages at blood donation (overall mean 12.5 weeks; no difference in gestational age was found within groups, p = 0.18). The overall PAPP-A serum level was 2.01 mIU/ml with only the spontaneous abortion group having a statistical different PAPP-A level (0.09 mIU/ml; p < 0.001).


CONCLUSIONS
These data suggest that those women who experienced spontaneous abortions had significantly different mean PAPP-A serum levels at 10(+1) to 14(+6) weeks gestation. Several lines of evidence suggest that downregulation of insulin-like growth factor-II availability due to a decreased PAPP-A serum level may be the cause of spontaneous abortion in these women.
Division of Reproductive Genetics, Fetal Medicine and Ultrasound, Department of Obstetrics and Gynecology, Amarillo Women's Health Research Institute, Texas Tech University Health Sciences Center, Amarillo, Tex., USA. jsf@ama.ttuhsc.edu
J
J
Santolaya-Forgas
J A
JA
De Leon
R
R
Cullen Hopkins
V D
VD
Castracane
R P
RP
Kauffman
G A
GA
Sifuentes
D000022:Abortion, Spontaneous / Q000097:blood* / Q000209:etiology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D018974:Insulin-Like Growth Factor Binding Protein 4 / Q000378:metabolism; D007335:Insulin-Like Growth Factor II / Q000378:metabolism; D008954:Models, Biological; D011247:Pregnancy; D011256:Pregnancy Outcome; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism*; D012189:Retrospective Studies
D018974:Insulin-Like Growth Factor Binding Protein 4; D007335:Insulin-Like Growth Factor II; D011266:Pregnancy-Associated Plasma Protein-A