Association between birth weight and first-trimester free beta-human chorionic gonadotropin and pregnancy-associated plasma protein A.
OBJECTIVE
To assess the relationship between first-trimester maternal serum PAPP-A and free beta-hCG and birth weight.


METHODS
Observational study.


METHODS
Teaching hospital.


METHODS
Singleton pregnancies (n = 1,630) at 10-14 weeks of gestation.


METHODS
Fluorimetric immunoassays for maternal serum pregnancy-associated plasma protein A (PAPP-A) and free beta-hCG.


METHODS
Customized birth weight percentiles, calculated taking into account maternal height, weight, ethnic origin, parity, smoking status, and fetal gender.


RESULTS
There was a significant positive correlation between birth weight and PAPP-A, but not free beta-hCG levels. Maternal serum levels of PAPP-A were significantly lower in small-for-gestation (SGA) newborns than in control subjects and were significantly higher in large-for-gestation (LGA) newborns than in control subjects. Maternal serum free beta-hCG levels were lower in pregnancies complicated by pre-eclampsia than in normotensive ones. Multivariable analysis found PAPP-A to be an independent predictor of absolute birth weight, SGA, and LGA. Free beta-hCG was found to be an independent predictor of gestational hypertension and pre-eclampsia. Neither of the two markers was associated with preterm delivery.


CONCLUSIONS
Maternal serum PAPP-A levels in the late first trimester of pregnancy are associated with subsequent fetal growth (including both physiologic variation and abnormal growth), and decreased free beta-hCG is more predictive of hypertensive disorders of pregnancy.
Canini
Silvana
S
Laboratorio di Analisi, Università di Genova, Genova, Italy.
Prefumo
Federico
F
Pastorino
Daniela
D
Crocetti
Lucia
L
Afflitto
Calogero Gallo
CG
Venturini
Pier Luigi
PL
De Biasio
Pierangela
P
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001724:Birth Weight; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D005260:Female; D047109:Fetal Development; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000097:blood / Q000503:physiopathology; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011225:Pre-Eclampsia / Q000097:blood / Q000503:physiopathology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism*; D047928:Premature Birth / Q000097:blood / Q000503:physiopathology; D011795:Surveys and Questionnaires
D015415:Biomarkers; D018997:Chorionic Gonadotropin, beta Subunit, Human; D011266:Pregnancy-Associated Plasma Protein-A