title: Correlation of first-trimester serum levels of pregnancy-associated plasma protein A with small-for-gestational-age neonates and preterm births.
abstract: OBJECTIVE
  To analyze the relationship between first-trimester levels of pregnancy-associated plasma protein A (PAPP-A) and small-for-gestational-age (SGA) neonates and preterm births, and to assess predictive utility for these events.
  
  
  METHODS
  A prospective study was conducted among women undergoing first-trimester screening between January 1, 2012, and December 31, 2013, at two centers in Pune, India. Serum PAPP-A levels, pregnancy course, and outcome were assessed.
  
  
  RESULTS
  Overall, 1474 women were included. An association was found between the lowest quintile of PAPP-A levels (<0.4 multiples of median) for both SGA (<10th centile; 20.9% of cases in this PAPP-A quintile) and preterm birth (<37weeks; 15.8%). Women in the lowest quintile of PAPP-A concentration had a significantly increased risk of SGA (<10th centile) than did those with higher concentrations (adjusted odds ratio 2.92, 95% confidence interval 2.00-4.27). Their risk of preterm birth (<37weeks) was also increased (adjusted odds ratio 1.84, 95% confidence interval 1.25-2.72). The predictive sensitivities of the lowest quintile of PAPP-A were 35.85% for SGA (<10th centile) and 27.92% for preterm birth (<37weeks).
  
  
  CONCLUSIONS
  Low levels of PAPP-A were associated with SGA and preterm births; however, poor predictive sensitivity could restrict clinical utility of this marker when used alone.
authors.affiliation: Division of Biochemistry, Department of Chemistry, Savitribai Phule Pune University, Pune, India.
authors.forename: Shridevi
authors.initials: S
authors.lastname: Gundu
authors.affiliation: Division of Biochemistry, Department of Chemistry, Savitribai Phule Pune University, Pune, India.
authors.forename: Mohan
authors.initials: M
authors.lastname: Kulkarni
authors.affiliation: Gupte Hospital and Research Center, Pune, India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Gupte
authors.affiliation: Gupte Hospital and Research Center, Pune, India.
authors.forename: Asmita
authors.initials: A
authors.lastname: Gupte
authors.affiliation: Division of Biochemistry, Department of Chemistry, Savitribai Phule Pune University, Pune, India; Birthright Genetic Clinic, Pune, India.
authors.forename: Maitreyee
authors.initials: M
authors.lastname: Gambhir
authors.affiliation: Birthright Genetic Clinic, Pune, India. Electronic address: drprakashgambhir@yahoo.com.
authors.forename: Prakash
authors.initials: P
authors.lastname: Gambhir
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood*; D005865:Gestational Age; D006801:Humans; D007194:India; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D016015:Logistic Models; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First / Q000097:blood*; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis*; D047928:Premature Birth / Q000175:diagnosis*; D011296:Prenatal Diagnosis / Q000379:methods*; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D018997:Chorionic Gonadotropin, beta Subunit, Human; D011266:Pregnancy-Associated Plasma Protein-A
keywords: Pregnancy; Pregnancy-associated plasma protein A; Preterm birth; Small for gestational age