Efficiency of first‐trimester growth restriction and low pregnancy‐associated plasma protein‐A in predicting small for gestational age at delivery

Carbone, J.; Tuuli, Methodius G.; Bradshaw, Rachael; Liebsch, Julie; Odibo, Anthony O.

doi:10.1002/pd.3891

Cited by 31 publications

(26 citation statements)

References 29 publications

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“…Studies in the literature report relationship between low PAPP-A level and SGA infant. It has been demonstrated that there was statistically significant relationship between PAPP-A level below fifth percentile or less than 0.4 MoM and SGA or IUGR [9, 21]. Abnormal placentation may be behind low level of PAPP-A and adverse outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Is there any relationship between low PAPP-A levels and measures of umbilical vein and placental thickness during first trimester of pregnancy?

Uysal

Tutuş

Çağlı

et al. 2017

North Clin Istanbul

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OBJECTIVE:Low pregnancy-associated plasma protein A (PAPP-A) level is associated with adverse perinatal outcomes. The purpose of this study was to evaluate relationship between umbilical cord diameter (UCD), umbilical vein and artery diameters (UVD, UAD), placental thickness, and PAPP-A level at gestational age of between 11 and 14 weeks.METHODS:UCD, UVD, UAD, and placental thickness of 246 women were assessed during ultrasound examination at between 11 and 14 weeks of gestation, as well as measurement of nuchal translucency (NT) and crown-rump length (CRL). Patients were divided into 2 groups according to PAPP-A percentile. Group 1 comprised 23 patients who had low PAPP-A (<0.44 multiple of medians [MoM], <10th percentile) and Group 2 was made up of 223 patients with PAPP-A of >0.44 MoM, >10th percentile. Calipers used for measurement were placed inner edge to inner edge of echogenic boundaries of the vessel. Largest sections of all vessels (UV and both arteries) were evaluated. Thickest part of the placenta was used for placental thickness measurement.RESULTS:Narrow UCD (<4.5±0.6 mm) was associated with low PAPP-A level (p=0.02). There was no significant difference in UVD, UAD, or placental thickness between groups. There was no significant difference in gestational age, CRL, or NT between groups. Fetal birth weight was significantly lower in Group 1 (p=0.03).CONCLUSION:Closer attention to women with low-risk, healthy pregnancies and low PAPP-A level in first trimester screening results is recommended. They should be routinely screened for background medical risk factors and umbilical cord morphology in first trimester scan.

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Section: Discussionmentioning

confidence: 99%

“…Low plasma level of PAPP-A has been recommended as biochemical marker for pregnancy with aneuploid fetus [8]. Moreover, low level has been observed in situations such as intrauterine growth restriction (IUGR) [9], preeclampsia [10], placental abruption, premature birth, fetus that is small for gestational age (SGA), and fetal death [11]. …”

mentioning

confidence: 99%

Is there any relationship between low PAPP-A levels and measures of umbilical vein and placental thickness during first trimester of pregnancy?

Uysal

Tutuş

Çağlı

et al. 2017

North Clin Istanbul

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“…3,5,6,14 O aumento da utilização dos marcadores bioquímicos no primeiro trimestre levou ao acréscimo de publicações científicas que demostraram igual relação destes marcadores com recém-nascidos LIG, sobretudo a PAPP-A. [1][2][3][4][5][11][12][13][14] A Tabela 4 sumariza os dados publicados em alguns destes estudos relativamente ao valor dos marcadores bioquími-cos e odds ratio calculados.…”

Section: Discussionunclassified

“…12,13 Estudos anteriores mostram que níveis baixos de PAPP-A estão associados, como factor independente, a um risco aumentado de recém-nascidos leves para a idade gestacional (LIG) [1][2][3]5,11,14 ou seja recém-nascidos com peso inferior ao percentil 10. A subunidade β da gonadotrofina coriónica humana (β-HCG) como marcador bioquímico do primeiro trimestre, também se encontra associada a estes recém-nascidos LIG quando se apresenta com valores baixos.…”

Section: 11unclassified

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Marcadores Bioquímicos do Primeiro Trimestre e Recém-Nascidos Leves para Idade Gestacional

et al. 2014

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Introduction: Several studies suggested an association between first trimester biochemical markers (PAPP-A and β- HCG) and infants below 10th percentile. Our goal was to describe this relationship of biochemical markers with small-for- gestational-age fetuses in our population. Material and Methods: Retrospective analytic study of 2 035 pregnant women that underwent first-trimester screening in the period between March 2009 and September 2011. Small-for-gestational-age infants below 10th percentile were compared with control group (term newborn with birth weight above 10th percentile). Infants below 3rd percentile and control group were also compared. Multiple and logistic regression analysis were done with PAPP-A, β-HCG (multiples of the expected normal median) and demographic maternal characteristics (ethnicity, weight and smoker status). Results: This study demonstrated an independent contribution of PAPP-A, maternal weight and smoker status in predicting small-for-gestational-age infants. For PAPP-A, the odds ratio for small-for-gestational age below 10th and 3rd percentile was 2.41 and 3.41, respectively (p < 0.01). For β-HCG, odds ratio below 10th percentile was 1.70 (p = 0.03) and for birth weight below the 3rd percentile, the odds ratio was 3.22 (p < 0.01). Conclusions: Low levels of PAPP-A and β-HCG (values below 5th percentile of the study population) were associated with an increased risk of small-for-gestational-age infants in the pregnant population included in this study.

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Fetal Growth Restriction

Bligard,

Odibo

2023

Queenan's Management of High‐Risk Pregnancy

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Efficiency of first‐trimester growth restriction and low pregnancy‐associated plasma protein‐A in predicting small for gestational age at delivery

Abstract: First-trimester FGR and PAPP-A<5th percentile are associated with delivery of an SGA infant. Neither of these parameters or the combination of the two are sufficient powerful predictors of SGA to be clinically useful screening tools.

Cited by 31 publications

References 29 publications

Is there any relationship between low PAPP-A levels and measures of umbilical vein and placental thickness during first trimester of pregnancy?

Is there any relationship between low PAPP-A levels and measures of umbilical vein and placental thickness during first trimester of pregnancy?

Marcadores Bioquímicos do Primeiro Trimestre e Recém-Nascidos Leves para Idade Gestacional

Fetal Growth Restriction

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