Low First Trimester Pregnancy-Associated Plasma Protein-A Levels Are Not Associated with an Increased Risk of Intrapartum Fetal Compromise or Adverse Neonatal Outcomes: A Retrospective Cohort Study
The aim of this study was to assess if women with a low first trimester maternal pregnancy-associated plasma protein-A (PAPP-A) level are at increased risk of emergency cesarean (EmCS) for intrapartum fetal compromise (IFC) and/or adverse neonatal outcomes. This was a retrospective cohort study perf...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-04-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/4/1108 |
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| author | Jessica M. Turner Sailesh Kumar |
| author_facet | Jessica M. Turner Sailesh Kumar |
| author_sort | Jessica M. Turner |
| collection | DOAJ |
| description | The aim of this study was to assess if women with a low first trimester maternal pregnancy-associated plasma protein-A (PAPP-A) level are at increased risk of emergency cesarean (EmCS) for intrapartum fetal compromise (IFC) and/or adverse neonatal outcomes. This was a retrospective cohort study performed at Mater Mother’s Hospital, Brisbane, Australia, between 2016 and 2018. All women with a singleton, euploid, non-anomalous fetus with a documented PAPP-A level measured between 10 <sup>+0</sup> and 13 <sup>+6</sup> weeks gestation during the study period were included. Data were extracted from the institution’s perinatal database and dichotomized according to PAPP-A level (≤0.4 Multiples of Medium (MoM) vs. >0.4 MoM). The primary outcomes were EmCS-IFC and a composite of severe adverse neonatal outcomes (SCNO). Nine thousand sixty-one pregnancies were included, 3.3% with a PAPP-A ≤ 0.4 MoM. Low maternal PAPP-A was not associated with an increased risk of EmCS-IFC (adjusted odds ratio (aOR) 0.77, 95% confidence interval (CI) 0.24–2.46, <i>p</i> = 0.66) or SCNO (aOR 0.65, 95% CI 0.39–1.07, <i>p</i> = 0.09). Low PAPP-A was associated with increased odds of pre-eclampsia, preterm birth and birthweight < 10th centile. In conclusion, low maternal PAPP-A level is not associated with an increased risk of EmCS IFC or adverse neonatal outcomes despite greater odds of low-birthweight infants and preterm birth. |
| first_indexed | 2024-03-10T20:29:51Z |
| format | Article |
| id | doaj.art-3f03d8dd0b184abdabc6420e24b94728 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T20:29:51Z |
| publishDate | 2020-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-3f03d8dd0b184abdabc6420e24b947282023-11-19T21:27:08ZengMDPI AGJournal of Clinical Medicine2077-03832020-04-0194110810.3390/jcm9041108Low First Trimester Pregnancy-Associated Plasma Protein-A Levels Are Not Associated with an Increased Risk of Intrapartum Fetal Compromise or Adverse Neonatal Outcomes: A Retrospective Cohort StudyJessica M. Turner0Sailesh Kumar1Mater Research Institute, University of Queensland, Raymond Terrace, Level 3 Aubigny Place, S. Brisbane, Queensland 4101, AustraliaMater Research Institute, University of Queensland, Raymond Terrace, Level 3 Aubigny Place, S. Brisbane, Queensland 4101, AustraliaThe aim of this study was to assess if women with a low first trimester maternal pregnancy-associated plasma protein-A (PAPP-A) level are at increased risk of emergency cesarean (EmCS) for intrapartum fetal compromise (IFC) and/or adverse neonatal outcomes. This was a retrospective cohort study performed at Mater Mother’s Hospital, Brisbane, Australia, between 2016 and 2018. All women with a singleton, euploid, non-anomalous fetus with a documented PAPP-A level measured between 10 <sup>+0</sup> and 13 <sup>+6</sup> weeks gestation during the study period were included. Data were extracted from the institution’s perinatal database and dichotomized according to PAPP-A level (≤0.4 Multiples of Medium (MoM) vs. >0.4 MoM). The primary outcomes were EmCS-IFC and a composite of severe adverse neonatal outcomes (SCNO). Nine thousand sixty-one pregnancies were included, 3.3% with a PAPP-A ≤ 0.4 MoM. Low maternal PAPP-A was not associated with an increased risk of EmCS-IFC (adjusted odds ratio (aOR) 0.77, 95% confidence interval (CI) 0.24–2.46, <i>p</i> = 0.66) or SCNO (aOR 0.65, 95% CI 0.39–1.07, <i>p</i> = 0.09). Low PAPP-A was associated with increased odds of pre-eclampsia, preterm birth and birthweight < 10th centile. In conclusion, low maternal PAPP-A level is not associated with an increased risk of EmCS IFC or adverse neonatal outcomes despite greater odds of low-birthweight infants and preterm birth.https://www.mdpi.com/2077-0383/9/4/1108fetal compromisePAPP-Aemergency cesarean birthadverse perinatal outcomesbiochemical markersbiomarker |
| spellingShingle | Jessica M. Turner Sailesh Kumar Low First Trimester Pregnancy-Associated Plasma Protein-A Levels Are Not Associated with an Increased Risk of Intrapartum Fetal Compromise or Adverse Neonatal Outcomes: A Retrospective Cohort Study Journal of Clinical Medicine fetal compromise PAPP-A emergency cesarean birth adverse perinatal outcomes biochemical markers biomarker |
| title | Low First Trimester Pregnancy-Associated Plasma Protein-A Levels Are Not Associated with an Increased Risk of Intrapartum Fetal Compromise or Adverse Neonatal Outcomes: A Retrospective Cohort Study |
| title_full | Low First Trimester Pregnancy-Associated Plasma Protein-A Levels Are Not Associated with an Increased Risk of Intrapartum Fetal Compromise or Adverse Neonatal Outcomes: A Retrospective Cohort Study |
| title_fullStr | Low First Trimester Pregnancy-Associated Plasma Protein-A Levels Are Not Associated with an Increased Risk of Intrapartum Fetal Compromise or Adverse Neonatal Outcomes: A Retrospective Cohort Study |
| title_full_unstemmed | Low First Trimester Pregnancy-Associated Plasma Protein-A Levels Are Not Associated with an Increased Risk of Intrapartum Fetal Compromise or Adverse Neonatal Outcomes: A Retrospective Cohort Study |
| title_short | Low First Trimester Pregnancy-Associated Plasma Protein-A Levels Are Not Associated with an Increased Risk of Intrapartum Fetal Compromise or Adverse Neonatal Outcomes: A Retrospective Cohort Study |
| title_sort | low first trimester pregnancy associated plasma protein a levels are not associated with an increased risk of intrapartum fetal compromise or adverse neonatal outcomes a retrospective cohort study |
| topic | fetal compromise PAPP-A emergency cesarean birth adverse perinatal outcomes biochemical markers biomarker |
| url | https://www.mdpi.com/2077-0383/9/4/1108 |
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