First trimester low maternal serum PAPP-A is associated with adverse pregnancy outcome, but predictive values are poor. Further work should address PAPP-A as a continuous variable in combination with other prognostic markers as a prediction model. © 2016 John Wiley & Sons, Ltd.

What's already known on this topic?Low levels of PAPP-A are associated with small for gestational age and pre-eclampsia. What does this study add?This article is protected by copyright. All rights reserved.NT, CRL and PAPP-A are independent prognostic markers for adverse pregnancy outcome.Further work is required to assess the predictive ability of these factors in prediction models. Abstract ObjectiveAre first trimester serum pregnancy-associated plasma protein-A (PAPP-A), nuchal translucency (NT) and crown rump length (CRL) prognostic factors for adverse pregnancy outcomes? MethodRetrospective cohort women, singleton pregnancies (UK 2011(UK -2015. Unadjusted and multivariable logistic regression, outcomes: small for gestational age (SGA), pre-eclampsia (PE), pre-term birth (PTB), miscarriage, stillbirth, perinatal mortality and neonatal death (NND). Results 12 ConclusionsPAPP-A, NT and CRL independent prognostic factor for adverse pregnancy outcomes, especially PAPP-A and SGA with lower PAPP-A associated with increased risk.

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