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Predictive value of pregnancy-associated plasma protein-A (PAPP-A) and free beta-hCG on fetal growth restriction: results of a prospective study

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Low levels of plasmatic pregnancy-associated plasma protein-A (PAPP-A) and high levels of free-beta human chorionic gonadotropin (beta-hCG) could influence the outcome of pregnancy. The objective of this study is to assess the correlation between PAPP-A and free beta-hCG and birth weight.

Materials and methods

Prospective follow-up study performed on 3332 patients in the first trimester of pregnancy who were subjected to a screening test focused on evaluation of fetal aneuploidy (SCA-TEST). The values of PAPP-A and free beta-hCG were both analyzed as raw values and subsequently converted to a multiple of the median (MoM). Statistical analysis was performed using SPSS version 17.0.1 (SPSS Inc., Chicago, USA).

Results

The incidence of “small for gestational age” in patients with PAPP-A MoM <1st and <5th ‰ was statistically significant (12 and 9.8 %; p < 0.0001). Also statistically significant data have been highlighted about free beta MoM > 95th ‰ (7 %; p = 0.03). The values of PAPP-A MoM > 99th ‰ are significantly correlated with an increased risk of “large for gestational age” (16.7 %; p < 0.0001).

Conclusion

Our study demonstrates that specific values of PAPP-A and free beta-hCG could identify the risk of low or high birth weight since the first trimester of pregnancy.

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Acknowledgments

The present article has been realized also thanks to the important scientific collaboration with Dr Francesca Romana Giorlandino (Department of Biochemistry - Altamedica Main Center - Rome - Italy) and Dr Diana Giannarelli (Department of Statistics - National Cancer Institute "Regina Elena" - Rome - Italy).

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Authors and Affiliations

  1. Division of Obstetrics and Gynaecology, Altamedica Main Center, Viale Liegi, 45, Rome, Italy

    Pietro Cignini & Lucia Mangiafico

  2. Division of Obstetrics and Gynaecology, University of Messina, Messina, Italy

    Laura Maggio Savasta

  3. Division of Obstetrics and Gynaecology, Department of Surgery, S. Bambino Hospital, University of Catania, Via Torresino, 22, Catania, Italy

    Ferdinando Antonio Gulino & Salvatore Giovanni Vitale

  4. Division of Medical Genetics, Altamedica Main Center, Viale Liegi, 45, Rome, Italy

    Alvaro Mesoraca

  5. Altamedica Main Center, Viale Liegi, 45, Rome, Italy

    Claudio Giorlandino

Authors
  1. Pietro Cignini
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  2. Laura Maggio Savasta
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  3. Ferdinando Antonio Gulino
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  4. Salvatore Giovanni Vitale
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  5. Lucia Mangiafico
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  6. Alvaro Mesoraca
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  7. Claudio Giorlandino
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Corresponding author

Correspondence to Ferdinando Antonio Gulino.

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The authors declare that they have no conflict of interest.

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Cignini, P., Savasta, L.M., Gulino, F.A. et al. Predictive value of pregnancy-associated plasma protein-A (PAPP-A) and free beta-hCG on fetal growth restriction: results of a prospective study. Arch Gynecol Obstet 293, 1227–1233 (2016). https://doi.org/10.1007/s00404-015-3947-z

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  • DOI: https://doi.org/10.1007/s00404-015-3947-z

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