title: Adverse pregnancy outcome in patients with low pregnancy-associated plasma protein-A: The Indian Experience.
abstract: OBJECTIVE
  The aim of our study was to examine the association of low pregnancy-associated plasma protein-A (PAPP-A) with adverse pregnancy outcome.
  
  
  METHODS
  A total of 1640 consecutive pregnant women between 9(+5) and 13(+6) weeks of pregnancy were recruited. One hundred and thirty women with PAPP-A levels < 0.4 multiple of median were followed till delivery and the outcome information was obtained for fetal loss, birthweight, growth restriction, preterm birth, reduced liquor and development of pre-eclampsia.
  
  
  RESULTS
  During the study period, 130 (7.92%) women had low PAPP-A and were considered as cases and 200 women with normal PAPP-A were controls. Intrauterine growth restriction was observed in 28 (21.54%) cases as compared to 10 (5%) controls. Pre-eclampsia presented in 24 (18.46%) cases and in 18 (9%) controls. Twenty (15.38%) cases had preterm delivery compared to 12 (6%) controls. Fifty-six (43.08%) cases delivered low-birthweight babies compared to 22 (11%) controls. Thus, the incidence of intrauterine growth restriction, preterm birth and low birthweight was significantly more in the cases as compared to the control group.
  
  
  CONCLUSIONS
  PAPP-A is a valuable analyte for predicting risk of adverse pregnancy outcome and women with low serum PAPP-A levels would benefit from closer surveillance.
authors.affiliation: Division of Fetal Medicine, Department of Obstetrics & Gynecology, Maulana Azad Medical College, New Delhi, India.
authors.forename: Sangeeta
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Division of Genetics & Metabolism, Department of Pediatrics, Maulana Azad Medical College, New Delhi, India.
authors.forename: Manisha
authors.initials: M
authors.lastname: Goyal
authors.affiliation: Department of Obstetrics & Gynecology, Maulana Azad Medical College, New Delhi, India.
authors.forename: Deepti
authors.initials: D
authors.lastname: Verma
authors.affiliation: Division of Genetics & Metabolism, Department of Pediatrics, Maulana Azad Medical College, New Delhi, India.
authors.forename: Anjana
authors.initials: A
authors.lastname: Sharma
authors.affiliation: Division of Genetics & Metabolism, Department of Pediatrics, Maulana Azad Medical College, New Delhi, India.
authors.forename: Namita
authors.initials: N
authors.lastname: Bharadwaj
authors.affiliation: Division of Genetics, Department Of Pediatrics, All India Institute Of Medical Sciences, New Delhi, India.
authors.forename: Madhulika
authors.initials: M
authors.lastname: Kabra
authors.affiliation: Division of Genetics & Metabolism, Department of Pediatrics, Maulana Azad Medical College, New Delhi, India.
authors.forename: Seema
authors.initials: S
authors.lastname: Kapoor
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D015536:Down-Regulation; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood* / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D062145:Maternal Serum Screening Tests; D007752:Obstetric Labor, Premature / Q000097:blood* / Q000453:epidemiology; D010865:Pilot Projects; D011225:Pre-Eclampsia / Q000097:blood* / Q000453:epidemiology; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D018566:Pregnancy, High-Risk / Q000097:blood*; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis*; D012306:Risk; D055815:Young Adult
chemical_list: D015415:Biomarkers; D011266:Pregnancy-Associated Plasma Protein-A; C579283:PAPPA protein, human
keywords: fetal loss; intrauterine growth restriction; pre-eclampsia; pregnancy outcome; preterm birth