Document Detail

Prediction of birth weight by fetal crown-rump length and maternal serum levels of pregnancy-associated plasma protein-A in the first trimester.
MedLine Citation:
PMID:  18098339     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine whether the first trimester crown-rump length (CRL), maternal serum levels of pregnancy-associated plasma protein A (PAPP-A) and free beta-human chorionic gonadotropin (fbeta-hCG) are independent predictors of birth weight. METHODS: This was an observational study over 1.5 years in Chinese patients who underwent first-trimester combined screening for Down syndrome in a University fetal medicine unit. After excluding cases with multiple pregnancies, congenital malformations and in-utero deaths, the relationship between fetal CRL (expressed as standardized Z-score (Z-CRL)), maternal PAPP-A and fbeta-hCG levels (expressed as log(10) of multiples of the median) and birth weight (Z-BW) were analyzed by Pearson's correlation test followed by multiple regression to check for their independency. The predictive power of the independent predictors for small-for-gestational age (SGA, defined as birth weight < 10(th) centile) was then assessed using receiver-operating characteristics (ROC) curves, and the likelihood ratios were derived. RESULTS: A total of 2760 cases were included. Z-CRL, log(10) PAPP-A(MoM), and log(10) fbeta-hCG were positively correlated with Z-BW (P < 0.0001), but only Z-CRL and log(10) PAPP-A(MoM) were independent predictors (P < 0.0001). The areas under the ROC curves of PAPP-A(MoM) and Z-CRL were 0.608 and 0.593, respectively (P < 0.0001). Likelihood ratios increased with decreasing PAPP-A(MoM) and Z-CRL, but were around 1 when the markers were at or above the mean. CONCLUSION: First-trimester CRL and PAPP-A are independent factors that influence final birth weight. The lower the PAPP-A and the smaller the CRL, the higher the risk of a fetus becoming SGA. However, their predictive powers are not sufficiently good for them to be used alone for SGA screening.
T Y Leung; D S Sahota; L W Chan; L W Law; T Y Fung; T N Leung; T K Lau
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  31     ISSN:  0960-7692     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2007-12-27     Completed Date:  2008-05-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  10-4     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2007 ISUOG. Published by John Wiley & Sons, Ltd.
Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong, China SAR.
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MeSH Terms
Biological Markers / metabolism
Birth Weight / physiology
Chorionic Gonadotropin, beta Subunit, Human / metabolism*
Crown-Rump Length*
Fetal Growth Retardation / diagnosis*
Predictive Value of Tests
Pregnancy Trimester, First / blood
Pregnancy-Associated Plasma Protein-A / metabolism*
Prenatal Diagnosis / methods*
Sensitivity and Specificity
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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