The relationship between first trimester fetal growth, pregnancy-associated plasma protein A levels and birthweight.
OBJECTIVE
We sought to define the relationship between first trimester fetal growth, pregnancy-associated plasma protein A (PAPP-A) levels and birthweight.


METHODS
Two-hundred and one women with repeat first trimester crown-rump length (CRL) measurements were included. In 194, the first trimester PAPP-A value was known and in 169 there was complete data including birthweight. Fetal growth curves were derived using functional linear discriminant analysis (FLDA) and growth compared between those with < 10th percentile, 10th to 90th and > 90th percentile PAPP-A multiple of median (MoM) levels and birthweight percentiles.


RESULTS
Median maternal age was 35 years, gestation at PAPP-A sampling and of first scan was 11 weeks. Median delivery gestation was 40 weeks and birthweight 3425 g. There was no association between first trimester fetal CRL growth and either PAPP-A MoM percentile or birthweight percentile. There was a significant positive correlation between PAPP-A MoM and birthweight percentile (p = 0.0004).


CONCLUSIONS
First trimester fetal growth rate is not related to birthweight percentile or first trimester PAPP-A levels. Irrespective of gestation, a low PAPP-A is associated with delivery of a smaller baby, and a high PAPP-A with a larger baby.
Habayeb
O
O
Division of Fetal-Maternal Medicine, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, UK.
Daemen
A
A
Timmerman
D
D
De Moor
B
B
Hackett
G A
GA
Bourne
T
T
Lees
C C
CC
D000328:Adult; D001724:Birth Weight; D018568:Crown-Rump Length; D016002:Discriminant Analysis; D005260:Female; D047109:Fetal Development / Q000502:physiology*; D006801:Humans; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood*; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism*; D011446:Prospective Studies; D016216:Ultrasonography, Prenatal
D011266:Pregnancy-Associated Plasma Protein-A