Document Detail


Association of first-trimester low PAPP-A levels with preterm birth.
MedLine Citation:
PMID:  20087924     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the association of, and predictive ability of, pregnancy-associated plasma protein A (PAPP-A), free beta-human chorionic gonadotrophin (beta-hCG), and nuchal translucency (NT) with preterm birth (PTB). METHODS: A 5-year retrospective cohort study of women who underwent first-trimester combined screening was performed. Maternal medical, antepartum, and pregnancy outcome data were obtained. PAPP-A and beta-hCG were converted to multiples of the median (MoM), and primary exposure was defined as < or =10th percentile MoM for PAPP-A. Secondary exposures were defined as > or = 90th percentile MoM for beta-hCG and NT values of > or = 20 and 25 mm. The primary outcome was PTB before 35 weeks and the secondary outcome was PTB before 32 weeks. Univariate, bivariate, multivariate, and receiver-operator analyses were used. RESULTS: Of the 2231 patients meeting inclusion criteria with complete outcome data available, 222 had a PAPP-A level < or =10th percentile MoM. Abnormally low PAPP-A was associated with an increased risk for PTB < 35 weeks [adjusted odds ratio (aOR) 2.0, 1.0-3.8] and < 32 weeks (aOR 2.7, 1.1-6.4), even after adjusting for prior PTB, tobacco exposure, chronic hypertension, and body mass index. PAPP-A < or =10th percentile was not sufficiently predictive of PTB < 35 weeks (area under curve = 0.63, 95% CI 0.53-0.72). Neither abnormally high beta-hCG nor increased NT was associated with an increased risk for PTB. CONCLUSIONS: PAPP-A < or =10th percentile is associated with an increased risk for PTB, but is not sufficiently predictive to be used clinically.
Authors:
Katherine R Goetzinger; Alison G Cahill; George A Macones; Anthony O Odibo
Related Documents :
2466704 - Rising human chorionic somatomammotropin predicts ectopic pregnancy rupture following m...
1383264 - Analysis of serum human chorionic gonadotrophin levels in normal singleton, multiple an...
2144494 - Treatment of tubal pregnancy by laparoscope-guided injection of prostaglandin f2 alpha.
3927064 - Maternal serum progesterone, 17 beta-estradiol and estriol are increased in pregnancies...
14561824 - Modulation of rhoa-rho kinase-mediated ca2+ sensitization of rabbit myometrium during p...
4009554 - Pregnant women's absorption of iron from prenatal supplements.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Prenatal diagnosis     Volume:  30     ISSN:  1097-0223     ISO Abbreviation:  Prenat. Diagn.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-07     Completed Date:  2010-06-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  England    
Other Details:
Languages:  eng     Pagination:  309-13     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 John Wiley & Sons, Ltd.
Affiliation:
Department of Obstetrics and Gynecology, Washington University School of Medicine, 4911 Barnes-Jewish Hospital Plaza, St. Louis, MO 63110, USA. goetzingerk@wudosis.wustl.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Chorionic Gonadotropin, beta Subunit, Human / blood
Female
Humans
Nuchal Translucency Measurement
Pregnancy
Pregnancy Trimester, First / blood
Pregnancy-Associated Plasma Protein-A / metabolism*
Premature Birth / blood*,  ultrasonography
Retrospective Studies
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin, beta Subunit, Human; EC 3.4.24.-/Pregnancy-Associated Plasma Protein-A

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Effect of religion on the attitude of primiparous women toward genetic testing.
Next Document:  Virus clearance reduces bone fracture in postmenopausal women with osteoporosis and chronic liver di...