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.
Salvig
J D
JD
Department of Obstetrics and Gynecology, Aarhus University Hospital, Skejby, DK-8200 Aarhus N, Denmark. salvig@dadlnet.dk
Kirkegaard
I
I
Winding
T N
TN
Henriksen
T B
TB
Tørring
N
N
Uldbjerg
N
N
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