title: Serum pregnancy-associated plasma protein A levels in the first, second and third trimester of pregnancy: relation to newborn anthropometric parameters and maternal tobacco smoking.
abstract: BACKGROUND
  The purpose of this study was to evaluate the associations of the first, second and third trimester serum pregnancy-associated plasma protein A (PAPP-A) concentrations with neonatal anthropometric parameters. The effect of tobacco smoking during pregnancy on PAPP-A level was also studied.
  
  
  METHODS
  One hundred and fifty healthy pregnant women were divided into smoking and tobacco-abstinent groups. Serum PAPP-A level was measured with the KRYPTOR rapid random-access immunoassay analyzer. The relationship between PAPP-A and newborn related outcome as well as markers of estimated intensity of cigarette smoking was evaluated by univariate and multivariate linear regression.
  
  
  RESULTS
  Pregnancy-associated plasma protein A concentration was positively correlated with birth weight in the first (β = 31.6;p< 0.001), second (β = 10.6;p< 0.05), and third (β = 4.6;p< 0.001) trimester of gestation. A significant association between PAPP-A and birth body length and head circumference in the second (β = 0.02;p< 0.05) and third trimester (β = 0.01;p< 0.01) was also found. The serum PAPP-A levels were significantly lower in the smoking than in the tobacco-abstinent group in each trimester of pregnancy (p< 0.001). The largest impact of the number of cigarettes smoked per day on PAPP-A level was found in the second (β = -1.2;p= 0.004) and third trimester (β = -2.6;p= 0.001).
  
  
  CONCLUSIONS
  Maternal serum PAPP-A levels during gestation might be significant predictors for birth weight. Increased PAPP-A concentrations in the second and third trimester appeared to also be predictive for newborn body length and head circumference. Smoking alters maternal PAPP-A levels in all trimesters, with the greatest impact related to the number of cigarettes smoked per day.
authors.affiliation: Screening Department, Institute of Mother and Child, Warsaw, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Chełchowska
authors.affiliation: Screening Department, Institute of Mother and Child, Warsaw, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Gajewska
authors.affiliation: Department of Child and Adolescent Health, Institute of Mother and Child, Warsaw, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Mazur
authors.affiliation: Screening Department, Institute of Mother and Child, Warsaw, Poland.
authors.forename: Jadwiga
authors.initials: J
authors.lastname: Ambroszkiewicz
authors.affiliation: Department of Obstetrics and Gynecology, Institute of Mother and Child, Warsaw, Poland.
authors.forename: Tomasz M
authors.initials: TM
authors.lastname: Maciejewski
authors.affiliation: Department of Obstetrics, Warsaw Medical University, Warsaw, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Leibschang
keywords: birth body length; birth weight; head circumference; pregnancy; pregnancy-associated plasma protein A; tobacco smoking