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Correlation of PAPP-A values with maternal characteristics, biochemical and ultrasonographic markers of pregrancy

Year 2021, Volume: 34 Issue: 1, 18 - 23, 29.01.2021
https://doi.org/10.5472/marumj.866601

Abstract

Objective: Our aim is to investigate whether there is a correlation of pregnancy-associated plasma protein A (PAPP-A) values with
other variables in pregnancy and maternal characteristics.
Materials and Methods: We retrospectively analyzed the relation between the pregnancy-associated plasma protein A levels,
demographics, biochemical and ultrasonographic markers of the first trimester screening of 11,842 pregnant women seen at a tertiary
hospital between November 2002 and November 2008.
Results: A significant difference between PAPP-A values of the diabetic and non-diabetic pregnant women were observed (p=0.0005,
Mann-Whitney U test). In terms of weight, crown-rump length, BetahCG values, significant differences were observed between
low and medium level PAPP-A subgroups and between low and high level PAPP-A subgroups. PAPP-A levels were found to differ
significantly between the pregnant women of Caucasian origin and other racial origins.
Conclusions: Pregnant women with different ethnic and medical backgrounds have different PAPP-A values and other markers of
the aneupleudity screening. To make patient specific risk predictions, understanding these interactions and differences is important.
Future studies are needed to understand the pathopyhsiology behind these differences.

References

  • Smith GC, Stenhouse EJ, Crossley JA, Aitken DA, Cameron AD, Connor JM. Early pregnancy levels of pregnancyassociated plasma protein a and the risk of intrauterine growth restriction, premature birth, preeclampsia, and stillbirth. J Clin Endocrinol Metab 2002;87:1762-7. doi: 10.1210/ jcem.87.4.8430.
  • Yaron Y, Heifetz S, Ochshorn Y, Lehavi O, Orr-Urtreger A. Decreased first trimester PAPP-A is a predictor of adverse pregnancy outcome. Prenat Diagn 2002;22:778-82. doi: 10.1002/pd.407.
  • Hanita O, Roslina O, Azlin MI. Maternal level of pregnancyassociated plasma protein A as a predictor of pregnancy failure in threatened abortion. Malays J Pathol 2012;34:145-51.
  • Cuckle H, Arbuzova S, Spencer K, et al. Frequency and clinical consequences of extremely high maternal serum PAPP-A levels. Prenat Diagn 2003;23:385-8. doi: 10.1002/pd.600.
  • Westergaard JG, Teisner B, Grudzinskas JG. Serum PAPP-A in normal pregnancy: relationship to fetal and maternal characteristics. Arch Gynecol 1983;233:211-5. doi: 10.1007/ BF02114602.
  • Wright D, Silva M, Papadopoulos S, Wright A, Nicolaides KH. Serum pregnancy-associated plasma protein-A in the three trimesters of pregnancy: effects of maternal characteristics and medical history. Ultrasound Obstet Gynecol 2015;46:42- 50. doi: 10.1002/uog.14870.
  • Browne JL, Klipstein-Grobusch K, Koster MP, et al. Pregnancy associated plasma protein-a and placental growth factor in a Sub-Saharan African population: A nested cross-sectional study. PLoS ONE 2016;11:e0159592. doi: 10.1371/journal. pone.0159592.
  • Donovan BM, Nidey NL, Jasper EA, et al. First trimester prenatal screening biomarkers and gestational diabetes mellitus: A systematic review and meta-analysis. PLoS ONE 2018;13: e0201319. doi.org/10.1371/journal.pone.0201319
  • Syngelaki A, Kotecha R, Pastides A, Wright A, Nicolaides KH. First-trimester biochemical markers of placentation in screening for gestational diabetes mellitus. Metabolism 2015;64:1485-9. doi: 10.1016/j.metabol.2015.07.015.
  • DiPrisco B, Kumar A, Kalra B, et al. Placental proteases PAPP-A and PAPP-A2, the binding proteins they cleave (IGFBP-4 and – 5), and IGF-I and IGF-II: Levels in umbilical cord blood and associations with birth weight and length. Metabolism 2019;100:153959. doi: 10.1016/j.metabol.2019.153959.
  • Lovati E, Beneventi F, Simonetta M, et al. Gestational diabetes mellitus: Including serum pregnancy-associated plasma protein-A testing in the clinical management of primiparous women? A case-control study. Diabetes Res Clin Pract 2013;100:340-7. doi: 10.1016/j.diabres.2013.04.002
  • Grewal J, Grantz KL, Zhang C, et al. Cohort profile: NICHD fetal growth studies-singletons and twins. Int J Epidemiol 2018;47:25-25l. doi:10.1093/ije/dyx161
  • Villar J, Papageorghiou AT, Pang R, et al. The likeness of fetal growth and newborn size across non-isolated populations in the INTERGROWTH-21st Project: the Fetal Growth Longitudinal Study and Newborn Cross-Sectional Study. Lancet Diabetes Endocrinol 2014;2:781-92. doi:10.1016/ S2213-8587(14)70121-4
  • Kiserud T, Piaggio G, Carroli G, et al. The World Health Organization Fetal Growth Charts: A Multinational Longitudinal Study of Ultrasound Biometric Measurements and Estimated Fetal Weight [published correction appears in PLoS Med 2017;14 (3):e1002284] [published correction appears in PLoS Med 2017;14 (4):e1002301]. PLoS Med 2017;14(1):e1002220. Published 2017 Jan 24. doi:10.1371/ journal.pmed.1002220
  • Bogin B, Varela-Silva MI. Leg length, body proportion, and health: a review with a note on beauty. Int J Environ Res Public Health 2010;7:1047-75. doi:10.3390/ijerph7031047
  • Clausson B, Lichtenstein P, Cnattingius S. Genetic influence on birthweight and gestational length determined by studies in offspring of twins. BJOG 2000;107:375-81. doi:10.1111/j.1471-0528.2000.tb13234.x.
  • Lunde A, Melve KK, Gjessing HK, Skjaerven R, Irgens LM. Genetic and environmental influences on birth weight, birth length, head circumference, and gestational age by use of population-based parent-offspring data. Am J Epidemiol 2007;165:734-41. doi:10.1093/aje/kwk107
  • Grantz KL, Hediger ML, Liu D, Buck Louis GM. Fetal growth standards: the NICHD fetal growth study approach in context with INTERGROWTH-21st and the World Health Organization Multicentre Growth Reference Study. Am J Obstet Gynecol 2018;218(2S):S641-S655.e28. doi:10.1016/j. ajog.2017.11.593
Year 2021, Volume: 34 Issue: 1, 18 - 23, 29.01.2021
https://doi.org/10.5472/marumj.866601

Abstract

References

  • Smith GC, Stenhouse EJ, Crossley JA, Aitken DA, Cameron AD, Connor JM. Early pregnancy levels of pregnancyassociated plasma protein a and the risk of intrauterine growth restriction, premature birth, preeclampsia, and stillbirth. J Clin Endocrinol Metab 2002;87:1762-7. doi: 10.1210/ jcem.87.4.8430.
  • Yaron Y, Heifetz S, Ochshorn Y, Lehavi O, Orr-Urtreger A. Decreased first trimester PAPP-A is a predictor of adverse pregnancy outcome. Prenat Diagn 2002;22:778-82. doi: 10.1002/pd.407.
  • Hanita O, Roslina O, Azlin MI. Maternal level of pregnancyassociated plasma protein A as a predictor of pregnancy failure in threatened abortion. Malays J Pathol 2012;34:145-51.
  • Cuckle H, Arbuzova S, Spencer K, et al. Frequency and clinical consequences of extremely high maternal serum PAPP-A levels. Prenat Diagn 2003;23:385-8. doi: 10.1002/pd.600.
  • Westergaard JG, Teisner B, Grudzinskas JG. Serum PAPP-A in normal pregnancy: relationship to fetal and maternal characteristics. Arch Gynecol 1983;233:211-5. doi: 10.1007/ BF02114602.
  • Wright D, Silva M, Papadopoulos S, Wright A, Nicolaides KH. Serum pregnancy-associated plasma protein-A in the three trimesters of pregnancy: effects of maternal characteristics and medical history. Ultrasound Obstet Gynecol 2015;46:42- 50. doi: 10.1002/uog.14870.
  • Browne JL, Klipstein-Grobusch K, Koster MP, et al. Pregnancy associated plasma protein-a and placental growth factor in a Sub-Saharan African population: A nested cross-sectional study. PLoS ONE 2016;11:e0159592. doi: 10.1371/journal. pone.0159592.
  • Donovan BM, Nidey NL, Jasper EA, et al. First trimester prenatal screening biomarkers and gestational diabetes mellitus: A systematic review and meta-analysis. PLoS ONE 2018;13: e0201319. doi.org/10.1371/journal.pone.0201319
  • Syngelaki A, Kotecha R, Pastides A, Wright A, Nicolaides KH. First-trimester biochemical markers of placentation in screening for gestational diabetes mellitus. Metabolism 2015;64:1485-9. doi: 10.1016/j.metabol.2015.07.015.
  • DiPrisco B, Kumar A, Kalra B, et al. Placental proteases PAPP-A and PAPP-A2, the binding proteins they cleave (IGFBP-4 and – 5), and IGF-I and IGF-II: Levels in umbilical cord blood and associations with birth weight and length. Metabolism 2019;100:153959. doi: 10.1016/j.metabol.2019.153959.
  • Lovati E, Beneventi F, Simonetta M, et al. Gestational diabetes mellitus: Including serum pregnancy-associated plasma protein-A testing in the clinical management of primiparous women? A case-control study. Diabetes Res Clin Pract 2013;100:340-7. doi: 10.1016/j.diabres.2013.04.002
  • Grewal J, Grantz KL, Zhang C, et al. Cohort profile: NICHD fetal growth studies-singletons and twins. Int J Epidemiol 2018;47:25-25l. doi:10.1093/ije/dyx161
  • Villar J, Papageorghiou AT, Pang R, et al. The likeness of fetal growth and newborn size across non-isolated populations in the INTERGROWTH-21st Project: the Fetal Growth Longitudinal Study and Newborn Cross-Sectional Study. Lancet Diabetes Endocrinol 2014;2:781-92. doi:10.1016/ S2213-8587(14)70121-4
  • Kiserud T, Piaggio G, Carroli G, et al. The World Health Organization Fetal Growth Charts: A Multinational Longitudinal Study of Ultrasound Biometric Measurements and Estimated Fetal Weight [published correction appears in PLoS Med 2017;14 (3):e1002284] [published correction appears in PLoS Med 2017;14 (4):e1002301]. PLoS Med 2017;14(1):e1002220. Published 2017 Jan 24. doi:10.1371/ journal.pmed.1002220
  • Bogin B, Varela-Silva MI. Leg length, body proportion, and health: a review with a note on beauty. Int J Environ Res Public Health 2010;7:1047-75. doi:10.3390/ijerph7031047
  • Clausson B, Lichtenstein P, Cnattingius S. Genetic influence on birthweight and gestational length determined by studies in offspring of twins. BJOG 2000;107:375-81. doi:10.1111/j.1471-0528.2000.tb13234.x.
  • Lunde A, Melve KK, Gjessing HK, Skjaerven R, Irgens LM. Genetic and environmental influences on birth weight, birth length, head circumference, and gestational age by use of population-based parent-offspring data. Am J Epidemiol 2007;165:734-41. doi:10.1093/aje/kwk107
  • Grantz KL, Hediger ML, Liu D, Buck Louis GM. Fetal growth standards: the NICHD fetal growth study approach in context with INTERGROWTH-21st and the World Health Organization Multicentre Growth Reference Study. Am J Obstet Gynecol 2018;218(2S):S641-S655.e28. doi:10.1016/j. ajog.2017.11.593
There are 18 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Original Articles
Authors

Hande Kaymakcalan This is me 0000-0001-7736-7634

Ommu Gulsum Uzut This is me 0000-0002-6602-772X

Juho Harkonen This is me 0000-0001-9687-1932

Burcu Bakır Gungor This is me 0000-0002-2272-6270

Publication Date January 29, 2021
Published in Issue Year 2021 Volume: 34 Issue: 1

Cite

APA Kaymakcalan, H., Uzut, O. G., Harkonen, J., Bakır Gungor, B. (2021). Correlation of PAPP-A values with maternal characteristics, biochemical and ultrasonographic markers of pregrancy. Marmara Medical Journal, 34(1), 18-23. https://doi.org/10.5472/marumj.866601
AMA Kaymakcalan H, Uzut OG, Harkonen J, Bakır Gungor B. Correlation of PAPP-A values with maternal characteristics, biochemical and ultrasonographic markers of pregrancy. Marmara Med J. January 2021;34(1):18-23. doi:10.5472/marumj.866601
Chicago Kaymakcalan, Hande, Ommu Gulsum Uzut, Juho Harkonen, and Burcu Bakır Gungor. “Correlation of PAPP-A Values With Maternal Characteristics, Biochemical and Ultrasonographic Markers of Pregrancy”. Marmara Medical Journal 34, no. 1 (January 2021): 18-23. https://doi.org/10.5472/marumj.866601.
EndNote Kaymakcalan H, Uzut OG, Harkonen J, Bakır Gungor B (January 1, 2021) Correlation of PAPP-A values with maternal characteristics, biochemical and ultrasonographic markers of pregrancy. Marmara Medical Journal 34 1 18–23.
IEEE H. Kaymakcalan, O. G. Uzut, J. Harkonen, and B. Bakır Gungor, “Correlation of PAPP-A values with maternal characteristics, biochemical and ultrasonographic markers of pregrancy”, Marmara Med J, vol. 34, no. 1, pp. 18–23, 2021, doi: 10.5472/marumj.866601.
ISNAD Kaymakcalan, Hande et al. “Correlation of PAPP-A Values With Maternal Characteristics, Biochemical and Ultrasonographic Markers of Pregrancy”. Marmara Medical Journal 34/1 (January 2021), 18-23. https://doi.org/10.5472/marumj.866601.
JAMA Kaymakcalan H, Uzut OG, Harkonen J, Bakır Gungor B. Correlation of PAPP-A values with maternal characteristics, biochemical and ultrasonographic markers of pregrancy. Marmara Med J. 2021;34:18–23.
MLA Kaymakcalan, Hande et al. “Correlation of PAPP-A Values With Maternal Characteristics, Biochemical and Ultrasonographic Markers of Pregrancy”. Marmara Medical Journal, vol. 34, no. 1, 2021, pp. 18-23, doi:10.5472/marumj.866601.
Vancouver Kaymakcalan H, Uzut OG, Harkonen J, Bakır Gungor B. Correlation of PAPP-A values with maternal characteristics, biochemical and ultrasonographic markers of pregrancy. Marmara Med J. 2021;34(1):18-23.