C A Spencer1, V M Allen, G Flowerdew, K Dooley, L Dodds. 1. Perinatal Epidemiology Research Unit, Department of Obstetrics and Gynaecology, Dalhousie University, Halifax, Nova Scotia, Canada.
Abstract
OBJECTIVES: To determine if low maternal serum level of pregnancy associated plasma protein A (PAPP-A) measured in early pregnancy can predict adverse pregnancy outcomes and to examine the gestational age (GA) sampling interval for these outcomes. METHODS: This was a nested case-control study from a prospective cohort of women recruited at <20 weeks of gestation in Halifax, NS. Cases (n=248) were defined as women who had a fetal loss or developed preeclampsia, severe pregnancy-induced hypertension (PIH), or small for gestational age infant (SGA). Controls (n=244) were frequency matched to cases by GA at the time of serum sampling (6 to <20 weeks GA). Participant information was obtained from questionnaires and medical chart reviews. RESULTS: Women with a low PAPP-A measure [<or=0.4 multiples of the median (MoM)] had an adjusted odds ratio of 2.1 [95% confidence interval (CI) 1.3-3.6] compared to others (>0.4 MoM). However, performance as a screening test was poor [sensitivity=38.7%; specificity=81.6%; positive likelihood ratio (LR)=2.1; negative LR=0.75]. In the adjusted model, the 10- to 14-week GA period was the only time period where low PAPP-A was significantly associated with adverse outcomes. CONCLUSIONS: Women with a low PAPP-A early in their pregnancy have twice the risk of an adverse outcome, though PAPP-A as a one-time single marker test has limited value.
OBJECTIVES: To determine if low maternal serum level of pregnancy associated plasma protein A (PAPP-A) measured in early pregnancy can predict adverse pregnancy outcomes and to examine the gestational age (GA) sampling interval for these outcomes. METHODS: This was a nested case-control study from a prospective cohort of women recruited at <20 weeks of gestation in Halifax, NS. Cases (n=248) were defined as women who had a fetal loss or developed preeclampsia, severe pregnancy-induced hypertension (PIH), or small for gestational age infant (SGA). Controls (n=244) were frequency matched to cases by GA at the time of serum sampling (6 to <20 weeks GA). Participant information was obtained from questionnaires and medical chart reviews. RESULTS:Women with a low PAPP-A measure [<or=0.4 multiples of the median (MoM)] had an adjusted odds ratio of 2.1 [95% confidence interval (CI) 1.3-3.6] compared to others (>0.4 MoM). However, performance as a screening test was poor [sensitivity=38.7%; specificity=81.6%; positive likelihood ratio (LR)=2.1; negative LR=0.75]. In the adjusted model, the 10- to 14-week GA period was the only time period where low PAPP-A was significantly associated with adverse outcomes. CONCLUSIONS:Women with a low PAPP-A early in their pregnancy have twice the risk of an adverse outcome, though PAPP-A as a one-time single marker test has limited value.
Authors: N Martínez-Sánchez; A Robles Marhuenda; M De la Calle Fernández-Miranda; J L Bartha Journal: Clin Rheumatol Date: 2021-02-09 Impact factor: 2.980
Authors: Shahryar K Kavoussi; Shu-Hung Chen; John David Wininger; Arnav Lal; William E Roudebush; Hayes C Lanford; Amy S Esqueda; Maya Barsky; Dan I Lebovic; Parviz K Kavoussi; Melissa S Gilkey; Justin Chen; Graham L Machen; Renee J Chosed Journal: J Assist Reprod Genet Date: 2022-01-11 Impact factor: 3.412