PAPP-A levels as an early marker of idiopathic preterm birth: a pilot study.
OBJECTIVE
To evaluate late PAPP-A levels as predictive of preterm birth in symptomatic women.


METHODS
Prospective cohort study of singleton gestations, 23 to 34 weeks, and symptoms of preterm labor. PAPP-A, IGF-I and IGF-III analysis were performed. Primary end point was delivery < or =7 days. Accuracy and optimally predictive PAPP-A values were based on receiver operator characteristic (ROC) curves.


RESULTS
In all, 26 women (51%) delivered < or =7 days post-admission (Group 1); 25 women (49%) >7 days (Group 2). Group 1 mean PAPP-A=38 000 vs 55 333 for Group 2 (P<0.04). Group 1 mean gestational age at delivery=29 weeks vs 37 weeks for Group 2 (P<0.00014). PAPP-A level < or =30,000 mU l(-1) had highest specificity (88%), sensitivity (50%), and positive predictive (81%) and negative predictive (62%) values for delivery < or =7 days. ROC area under curve=0.703.


CONCLUSIONS
PAPP-A levels < or =30,000 mU l(-1) at admission was associated with increased risk for preterm birth < or =7 days, supporting active management and therapeutic approach in these women.
Grisaru-Granovsky
S
S
Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Jerusalem, Israel.
Halevy
T
T
Planer
D
D
Elstein
D
D
Eidelman
A
A
Samueloff
A
A
D000328:Adult; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D016013:Likelihood Functions; D007752:Obstetric Labor, Premature / Q000097:blood* / Q000175:diagnosis / Q000628:therapy; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011247:Pregnancy; D011266:Pregnancy-Associated Plasma Protein-A; D011446:Prospective Studies; D013002:Somatomedins / Q000378:metabolism*; D015145:Tocolysis
D013002:Somatomedins; D011266:Pregnancy-Associated Plasma Protein-A