The efficacy of first-trimester PAPP-A and free beta hCG levels for predicting adverse pregnancy outcome.
OBJECTIVE
To determine whether first-trimester measurements of maternal serum PAPP-A and free beta hCG levels were associated with adverse pregnancy outcomes.


METHODS
First trimester maternal serum free beta hCG and PAPP-A were measured in 490 singleton pregnancies. Pregnancies were followed by the fetal-maternal unit, and predictive efficacy of these markers for small for gestational age (SGA) babies, gestational diabetes mellitus and hypertensive disorders were analyzed by cut-off values determined by using a ROC analysis, and also, by using the fifth percentile as the cut-off value.


RESULTS
The sensitivities for PAPP-A in predicting pregnancies with a SGA baby and those complicated by a hypertensive disorder were 49% and 73%, respectively, when optimal cut-off values were used. Specificities were 76% and 65%, respectively. Serum free beta hCG had no predictive value for individual pregnancy outcomes.


CONCLUSIONS
Efficacy of first trimester maternal serum markers in predicting adverse pregnancy outcome is low. Even after optimization of cut-off values, these markers do not appear to be clinically acceptable as an effective tool for screening for adverse pregnancy outcomes.
Kavak
Zehra Nese
ZN
Marmara University School of Medicine, Istanbul, Turkey.
Basgul
Alin
A
Elter
Koray
K
Uygur
Meltem
M
Gokaslan
Husnu
H
D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D016640:Diabetes, Gestational / Q000175:diagnosis; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000175:diagnosis; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood*; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism*; D011296:Prenatal Diagnosis / Q000379:methods*; D012372:ROC Curve
D018997:Chorionic Gonadotropin, beta Subunit, Human; D011266:Pregnancy-Associated Plasma Protein-A