title: First-trimester pregnancy-associated plasma protein A and subsequent abnormalities of fetal growth.
abstract: OBJECTIVE
  The purpose of this study was to describe the relationship between first-trimester pregnancy-associated plasma protein A (PAPP-A) and birthweight along its continuum and at its extremes.
  
  
  METHODS
  This was a retrospective cohort of 1371 women who underwent first-trimester screening for fetal aneuploidy and who delivered at our hospital.
  
  
  RESULTS
  First-trimester PAPP-A has a positive relationship with birthweight. As PAPP-A decreases, the risk of small-for-gestational-age (SGA) infants increases. PAPP-A of <10%, <5%, and <1% were associated with an increasing adjusted odds ratio for SGA infants (2.0 [95% CI, 1.2-3.5; P = .012]; 2.4 [95% CI, 1.2-4.7; P = .015]; 9.3 [95% CI, 3.4-25.5; P = .001], respectively). PAPP-A levels of >90% were associated with an adjusted odds ratio for birthweight of >4500 g of 2.9 (95% CI, 1.02-8.17; P = 0.046).
  
  
  CONCLUSIONS
  First-trimester PAPP-A is a marker of placental function that correlates with birthweight along its continuum and at its extremes. The strong association between low PAPP-A and SGA warrants further investigation of its usefulness as a screening tool.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Suzanne E
authors.initials: SE
authors.lastname: Peterson
authors.forename: Hyagriv N
authors.initials: HN
authors.lastname: Simhan
mesh_terms: D000328:Adult; D001724:Birth Weight / Q000502:physiology*; D015986:Confounding Factors, Epidemiologic; D005260:Female; D047109:Fetal Development / Q000502:physiology*; D006801:Humans; D016015:Logistic Models; D016017:Odds Ratio; D010920:Placenta / Q000502:physiology*; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000502:physiology*; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis*; D012189:Retrospective Studies
chemical_list: D011266:Pregnancy-Associated Plasma Protein-A