Low Pregnancy Associated Plasma Protein A as a Predictive Tool for Pregnancy Outcome

Abstract

Objective: The objective of this study is to identify the predictive value of pregnancy-associated plasma protein A using univariate and multivariate regression analysis in identification of patients with low values (less than 0.4 MoM) in combined first-trimester screening for predicting disadvantaged perinatal outcome after exclusion of aneuploidy. Methods: A study was conducted at the University clinic for gynecology and obstetrics in Skopje, over a one-year period (2018 y). Those with PAPP-A values (<0.4 MoM) of 64 and a control group of 50 patients with values ≥0.4 MoM. The concentration of PAPP-A was measured from peripheral blood and determined by Immulite 2000 HPi Systems Analyzer. Results: Univariate and multivariate logistic regression analyses were used to assess the predictive role of PAPP-A. The unadjusted OR for PAPP-A for preterm delivery was 0.225, for antepartum complications was 0.138, for intrauterine growth restriction of 0.049. In the adjusted logistic regression analysis, PAPP-A was not found to be a significant predictor of respiratory distress syndrome, newborn infections, NICU stay and pH≤7.2. The adjusted OR for antepartum complications was 0.131, for intrauterine growth restriction was 0.053. Conclusion: It can be concluded that PAPP-A levels in the first trimester are associated with intrauterine growth restriction and antepartum complications. The study suggests that caution is needed in pregnancies with PAPP-A values below 0.3 MoM.