Low PAPP-A in the first trimester is associated with reduced fetal growth rate prior to gestational week 20.
OBJECTIVE
To evaluate the association between maternal pregnancy-associated plasma protein-A (PAPP-A) and fetal growth from the first to the second trimester.


METHODS
A prospective cohort study including 8347 pregnant women attending prenatal care at Aarhus University Hospital were conducted. PAPP-A was measured during 8 to 14 gestational weeks. Fetal growth between the two scans in the first and second trimesters was estimated by (GA(20)- GA(12))/Days(calendar), where GA(12) reflects gestational age in days calculated from crown-rump length at a 12-week scan, GA(20) reflects gestational age in days calculated from biparietal diameter at a 20-week scan, and Days(calendar) reflects the number of calendar days between the two scans.


RESULTS
Fetal growth rate from the first to the second trimester was correlated with PAPP-A, with a regression coefficient of 0.009 (95% CI, 0.007-0.012, P < 0.001). PAPP-A below 0.30 MoM was associated with a fetal growth rate below the tenth centile, with an adjusted OR of 2.05 (95% CI, 1.24-3.38).


CONCLUSIONS
Low levels of PAPP-A are associated not only with low birth weight at term but also with slower fetal growth prior to 20 weeks of gestation.
Department of Obstetrics and Gynecology, Aarhus University Hospital, Skejby, DK-8200 Aarhus N, Denmark. salvig@dadlnet.dk
J D
JD
Salvig
I
I
Kirkegaard
T N
TN
Winding
T B
TB
Henriksen
N
N
Tørring
N
N
Uldbjerg
D000328:Adult; D015415:Biomarkers / Q000032:analysis / Q000097:blood / Q000378:metabolism; D015331:Cohort Studies; D015536:Down-Regulation; D005260:Female; D047109:Fetal Development / Q000502:physiology; D005317:Fetal Growth Retardation / Q000097:blood* / Q000175:diagnosis; D005865:Gestational Age; D006801:Humans; D007230:Infant, Low Birth Weight / Q000502:physiology; D007231:Infant, Newborn; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood*; D011262:Pregnancy Trimester, Second / Q000097:blood; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis*; D011296:Prenatal Diagnosis; D054928:Validation Studies as Topic
D015415:Biomarkers; D011266:Pregnancy-Associated Plasma Protein-A