Pregnancy- Associated Plasma Protein A and Pregnancy Outcomes

V. Radoi, L.C. Bohiltea

Abstract: The purpose of this study is to assess the relationship between the first-trimester maternal serum pregnancy-associated plasma protein-A (PAPP-A) levels and pregnancy complications. The risk of adverse perinatal outcome among 484 women recruited to Life Memorial Hospital, in a prospective nonintervention cohort study was related to maternal circulating concentrations of trophoblast-derived proteins at 10-13+6 wk gestation. In this study, we demonstrate that maternal circulating concentrations of PAPP-A at 10-13+6 wk gestation are significantly predictive of adverse perinatal outcome in later pregnancy. Women with a pregnancy-associated plasma protein A (PAPP-A) in the lowest fifth percentile at 10- 13+6 wk gestation had an increased risk of intrauterine growth restriction, premature delivery, preeclampsia and stillbirth. In contrast, levels of free ß-human CG, another circulating protein synthesized by the syncytiotrophoblast, were not predictive of later outcome. PAPP-A has been identified as a protease specific for IGF binding proteins. Control of the IGF system in the first and early second trimester trophoblast may have a key role in determining subsequent pregnancy outcome.
Keywords: Pregnancy-Associated Plasma Protein A, Insulin-like growth factor, adverse pregnancy outcomes