Document Detail

Frequency and clinical consequences of extremely high maternal serum PAPP-A levels.
MedLine Citation:
PMID:  12749035     Owner:  NLM     Status:  MEDLINE    
A multicentre study was carried out to determine the frequency and clinical consequences of extremely high maternal serum pregnancy-associated plasma protein (PAPP)-A. There was a total of 79 pregnancies with PAPP-A exceeding 5.0 multiples of the gestation-specific median in a series of 46 776 pregnancies tested (0.2%) at the 7 collaborating centres. Five pregnancies were lost to follow-up, one miscarried and one with Noonan's syndrome was terminated. Of the remaining 72 that ended in a live birth, one infant had gastroschisis and five pregnancies had obstetric complications: pre-eclampsia, pregnancy-induced hypertension, gestational diabetes and two with growth retardation. Among women with high PAPP-A and no complications or adverse outcomes, there was no evidence of a substantial change in the levels of other Down syndrome markers or the extent of nuchal translucency. Three analytical methods were used to assay PAPP-A and yielded different frequencies of extremely high levels (0.05%, 0.4% and 0.6%) possibly owing to cross-reaction with another substance. We conclude that women with high PAPP-A can be reassured that there is no reason to suppose that the outcome of pregnancy will differ from those with normal levels, provided other markers are normal. If, as more centres move their Down syndrome screening practice to the first trimester, additional cases emerge with Noonan's syndrome or gastroschisis and raised PAPP-A, this advice will need to be modified.
H Cuckle; S Arbuzova; K Spencer; J Crossley; G Barkai; D Krantz; F Muller; M Nikolenko; D Aitken; T Hallahan; J Macri; P D Buchanan
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Prenatal diagnosis     Volume:  23     ISSN:  0197-3851     ISO Abbreviation:  Prenat. Diagn.     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-05-15     Completed Date:  2003-08-26     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  England    
Other Details:
Languages:  eng     Pagination:  385-8     Citation Subset:  IM    
Copyright Information:
Copyright 2003 John Wiley & Sons, Ltd.
Reproductive Epidemiology, University of Leeds, UK.
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MeSH Terms
Down Syndrome / diagnosis
Mass Screening
Pregnancy / blood*
Pregnancy Outcome*
Pregnancy Trimester, First
Pregnancy-Associated Plasma Protein-A / metabolism*
Prenatal Diagnosis
Reg. No./Substance:
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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