Document Detail

PAPP-A, free β-hCG, and early fetal growth identify two pathways leading to preterm delivery.
MedLine Citation:
PMID:  20721873     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate early fetal growth and the biomarkers, pregnancy-associated plasma protein A (PAPP-A) and free β-human chorionic gonadotrophin (β-hCG), in relation to preterm delivery.
METHODS: A cohort study of 9450 singleton pregnant women who attended the prenatal screening program at Aarhus University Hospital between January 2005 and December 2007, was conducted. PAPP-A and free β-hCG were measured in the first trimester. Early fetal growth was estimated by (GA(20)- GA(12))/Days(calendar), where GA(12) reflects the gestational age in days calculated from the crown-rump length at a 12-week scan, GA(20) reflects the gestational age in days calculated from the biparietal diameter at a 20-week scan, and Days(calendar) is the number of calendar days between the two scans.
RESULTS: Low PAPP-A and low free β-hCG were significantly associated with preterm delivery (<37 weeks). The association was even stronger when low PAPP-A and slow early fetal growth were combined, resulting in an adjusted odds ratio of 3.8 (95% CI, 1.6-8.7). Fast early fetal growth, but neither high PAPP-A nor high free β-hCG, was significantly associated with preterm delivery.
CONCLUSION: Two different biological pathways leading to spontaneous preterm delivery are suggested: fast early fetal growth and the combination of low PAPP-A and slow early fetal growth.
Ida Kirkegaard; Niels Uldbjerg; Olav Bjørn Petersen; Niels Tørring; Tine Brink Henriksen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Prenatal diagnosis     Volume:  30     ISSN:  1097-0223     ISO Abbreviation:  Prenat. Diagn.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-29     Completed Date:  2011-01-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106540     Medline TA:  Prenat Diagn     Country:  England    
Other Details:
Languages:  eng     Pagination:  956-63     Citation Subset:  IM    
Copyright Information:
© 2010 John Wiley & Sons, Ltd.
Perinatal Epidemiology Research Unit, Aarhus University Hospital, Skejby, Aarhus, Denmark.
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MeSH Terms
Biological Markers / blood
Chorionic Gonadotropin, beta Subunit, Human / blood*
Cohort Studies
Crown-Rump Length
Denmark / epidemiology
Fetal Development / physiology*
Gestational Age
Maternal Age
Pregnancy / blood*
Pregnancy-Associated Plasma Protein-A / metabolism*
Premature Birth / blood*,  epidemiology
Reg. No./Substance:
0/Biological Markers; 0/Chorionic Gonadotropin, beta Subunit, Human; EC 3.4.24.-/Pregnancy-Associated Plasma Protein-A

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