Serum level of PAPPA-A (pregnancy associated plasma protein-A) at first trimesterand its relation with adverse pregnancy outcome

Background: PAPP-A is a preterm marker for undesirable pregnancy diagnosis. The relationship between PAPP-A serum levels and maternal health, especially gestational diabetes, which is the most common outcome of pregnancy, is a major issue that needs to be studied. The aim of this study were to evaluate the serum level of PAPP-A and pregnancy outcomes.

Methods: in this study all pregnant women who referred to the pregnancy care clinics during their first 3 months, serum levels of PAPP-A were evaluated. As their PAPP-A serum level were less than 0.4 Mom, they were considered as risk-positive and pregnant women with a serum PAPP-A level of more than 0.4 MM as a control group. In the subjects, maternal age, serum PAPP-A level, type of delivery, gestational age, intrauterine growth restriction, preeclampsia, spontaneous abortion, and gestational diabetes were evaluated.

Results: The mean age of pregnant women were 26.85 ±4.74 years. There were a significant reverse correlation between serum concentration of first trimesters PAPP-A and preeclampsia (p=0.003), pregnancy Diabetes (p=0.003), restriction of intrauterine growth (p=0.005) and spontaneous abortion (p=0.04), but there were not significant corrections between serum level of PAPP-A with early birth (p=0.102) and gestation type (p=0.583).

Conclusion: A reduced amount of first trimester PAPP-A would used as a probable risk factor in complications of pregnancy or embryo including preeclampsia, Gestational Diabetes, restriction of intrauterine growth and spontaneous abortion.