| Association of first-trimester low PAPP-A levels with preterm birth. | |
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MedLine Citation:
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PMID: 20087924 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Katherine R Goetzinger; Alison G Cahill; George A Macones; Anthony O Odibo |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Prenatal diagnosis Volume: 30 ISSN: 1097-0223 ISO Abbreviation: Prenat. Diagn. Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-04-07 Completed Date: 2010-06-29 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8106540 Medline TA: Prenat Diagn Country: England |
Other Details:
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Languages: eng Pagination: 309-13 Citation Subset: IM |
Copyright Information:
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Copyright (c) 2010 John Wiley & Sons, Ltd. |
Affiliation:
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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:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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
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