Low pregnancy-associated plasma protein-A levels up risk of pre-eclampsia
Low serum levels of pregnancy-associated plasma protein-A (PAPP-A) appears to increase the risk of early development pre-eclampsia, a recent study has shown.
The researchers performed a cohort study on 3,663 pregnant females with singleton pregnancies undergoing screening for foetal Down syndrome. In the cohort, 357 had low PAPP-A and were designated as the study group, while the remaining 3,306 were identified as controls. Maternal weight was significantly higher in the study vs control group (58.0±9.6 vs 53.5±8.0 kg; p<0.001).
In terms of pre-eclampsia, the prevalence rate was significantly higher in the study group compared with the control group (8.4 vs 2.6 percent; p<0.0001). Early-onset pre-eclampsia was also significantly more common in the study group (1.1 vs 0.1 percent; p=0.0016). The respective overall rates were 3.1 and 0.2 percent.
Risk analysis showed the same results. Those with lower serum PAPP-A levels had significantly elevated risks of pre-eclampsia (relative risk [RR], 3.27; 95 percent CI, 2.19–4.88) and early-onset pre-eclampsia (RR, 9.26; 2.33–36.87).
Low PAPP-A concentrations showed acceptable diagnostic indices, with a sensitivity of 26.1 percent and a specificity of 90.8 percent. The positive and negative predictive values were calculated to be 8.4 percent and 97.4 percent, respectively.
Decreased vs normal PAPP-A levels were also associated with other adverse birth outcomes, such as low birth weight (2,746±945 vs 3,035±526 g; p<0.001), stillbirth (9.5 percent vs 1.3 percent; p<0.0001), low Apgar scores (p<0.0001), preterm birth (16.2 percent vs 8.0 percent; p<0.0001) and foetal growth restrictions (10.9 percent vs 6.5 percent; p=0.002).