title: Predicting SGA neonates using first-trimester screening: influence of previous pregnancy's birthweight and PAPP-A MoM.
abstract: OBJECTIVE
  Investigating the proportions of anamnestic and biochemical variables of the previous and current pregnancies for the prediction of small for gestational age (SGA) neonates in the current pregnancy.
  
  
  METHODS
  In this observational retrospective study, 45 029 pregnancies were examined, including 3862 patients with more than one pregnancy. Odds ratios for SGA using anamnestic parameters and pregnancy-associated plasma protein A (PAPP-A) values from all pregnancies were estimated by using a logistic regression model.
  
  
  RESULTS
  There were 2552 (5.7%) SGA neonates. Two threshold PAPP-A values were identified at 0.15 MoM and 0.33 MoM with probabilities for SGA of 23% and 17%, respectively. A previous SGA < 10th centile and a current PAPP-A MoM value < 5th centile result in odds ratios of 4.8 (95% CI: 3.5-6.5) and 3.0 (95% CI: 1.8-5.0), respectively. The parameters' combined odds ratio is 14.1 (95% CI: 3.9-50.3) with a number needed to screen of ten for one SGA neonate at a detection rate of 37%.
  
  
  CONCLUSIONS
  Information on previous pregnancies affected by SGA and a current pregnancy's low PAPP-A value are reliable predictors for a SGA delivery. First-trimester biochemical analysis should be maintained to detect women at risk for delivering a SGA neonate.
authors.affiliation: a Praenatal-Medizin Und Genetik Düsseldorf , Düsseldorf, NRW , Germany and.
authors.forename: Alexandra Lara
authors.initials: AL
authors.lastname: Krauskopf
authors.affiliation: a Praenatal-Medizin Und Genetik Düsseldorf , Düsseldorf, NRW , Germany and.
authors.forename: Alexander Johannes
authors.initials: AJ
authors.lastname: Knippel
authors.affiliation: b Coordination Center for Clinical Trials, University of Düsseldorf , Düsseldorf, NRW , Germany.
authors.forename: Pablo Emilio
authors.initials: PE
authors.lastname: Verde
authors.affiliation: a Praenatal-Medizin Und Genetik Düsseldorf , Düsseldorf, NRW , Germany and.
authors.forename: Peter
authors.initials: P
authors.lastname: Kozlowski
mesh_terms: D000328:Adult; D001724:Birth Weight; D005260:Female; D005865:Gestational Age; D020073:Gravidity; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000097:blood*; D016015:Logistic Models; D016017:Odds Ratio; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000097:blood*; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis*; D011296:Prenatal Diagnosis / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors
chemical_list: D011266:Pregnancy-Associated Plasma Protein-A
keywords: Maternity care; obstetrics; prenatal diagnosis