Maternal serum placental growth factor and pregnancy-associated plasma protein A measured in the first trimester as parameters of subsequent pre-eclampsia and small-for-gestational-age infants: A prospective observational study.
10.5468/ogs.2017.60.2.154
- Author:
Kyung Uk SUNG
1
;
Jeong A ROH
;
Kyung Jin EOH
;
Eui Hyeok KIM
Author Information
1. Department of Obstetrics and Gynecology, National Health Insurance Service Ilsan Hospital, Goyang, Korea. raksumi10@gmail.com
- Publication Type:Original Article
- Keywords:
Placental growth factor;
Pre-eclampsia;
Pregnancy-associated plasma protein A;
Small-for-gestational-age infant
- MeSH:
Diabetes, Gestational;
Female;
Follow-Up Studies;
Humans;
Infant*;
Logistic Models;
Maternal Age;
Medical Records;
Observational Study*;
Odds Ratio;
Plasma*;
Pre-Eclampsia*;
Pregnancy;
Pregnancy Trimester, First*;
Pregnancy Trimester, Second;
Pregnancy, Twin;
Pregnancy-Associated Plasma Protein-A;
Pregnant Women;
Prospective Studies*;
Risk Factors;
Staphylococcal Protein A*;
Uterine Artery
- From:Obstetrics & Gynecology Science
2017;60(2):154-162
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To examine the first-trimester maternal serum placental growth factor (PlGF) and pregnancy-associated plasma protein A (PAPP-A) levels in pregnancies associated with pre-eclampsia (PE) or small-for-gestational-age (SGA) infants, and determine the predictive accuracy of PlGF and of PAPP-A for either PE or SGA infants. METHODS: This prospective, observational study included 175 pregnant women, and of these women, due to participant withdrawal or loss to follow-up, delivery data were collected from the medical records of 155 women, including 4 who had twin pregnancies. The women's maternal history was recorded, and the PlGF and PAPP-A levels at 11 to 13 gestational weeks were measured. During the second trimester, the maternal uterine artery's systolic/diastolic ratio was measured. Multiples of the median (MoM) of PlGF and PAPP-A were determined, and the associations of these values with the risk factors of SGA and PE were evaluated. Logistic regression analysis was used to determine whether PlGF and PAPP-A are useful markers for predicting SGA infants. RESULTS: The PAPP-A MoM level was significantly lower in women with advanced maternal age, multipara women, and women with gestational diabetes than in their counterparts. The PlGF and PAPP-A MoM levels were higher in women with a twin pregnancy than in those with a singleton pregnancy. There was a significant relationship between the maternal serum PAPP-A MoM level in the first trimester and the uterine artery systolic/diastolic ratio in the second trimester. Results of logistic regression analysis showed that low PlGF and PAPP-A MoM levels were predictors of SGA infants (odds ratio, 0.143; 95% confidence interval, 0.025 to 0.806; odds ratio, 0.191; 95% confidence interval, 0.051 to 0.718, respectively). CONCLUSION: PlGF and PAPP-A are potentially useful as first-trimester markers for SGA infants and some hypertensive disorders of pregnancy.
