Background/Aim. Pregnancy-associated plasma protein A (PAPP-A) is high
molecular matrix metalloproteinase originally isolated in the serum of
pregnant women. The aim of this study was to analyze the values of
concentration of PAPP-A in assessment of progress and outcome of pregnancy in
pregnant women diagnosed with threatening preterm delivery, preeclampsia and
fetal growth restriction in relation to physiological pregnancy of the same
gestational age. Methods. The study included 60 pregnant women that were
divided into three groups according to gestational age and the diagnosis of
imminent premature birth upon reception, preeclampsia and fetal growth
restriction as follows: the group I from 28 to 32 weeks of gestation, a total
of 25 pregnant women, the group II from 33 to 36 weeks of gestation, a total
of 23 pregnant women, and the group III from 37 to 41 weeks of gestation, a
total of 12 pregnant women. The control group consisted of 60 pregnant women
without complications of pregnancy that were identically divided into three
groups according to gestational age as in the sample. We performed
quantitative determination of PAPP-A from the venous blood of patients by
using commercial tests of the company Diagnostics Product Corporation (DPC),
Los Angeles, California, USA. Results. There was a statistically significant
difference in PAPP-A values in the examined groups in all gestational ages (p
< 0.01). The value of the PAPP-A concentration in different gestational ages
with equal statistical significance indicated the possibility of
complications, which was examined during pregnancy in relation to the control
group of pregnant women with physiological pregnancies. This study confirmed
that there was a statistically significant difference in fetal body weight at
birth (p < 0.05), Apgar score in 5 min after birth (p < 0.05), and
gestational age at birth (p < 0.05), as parameters of the outcome of
pregnancy course, between the examined groups of pregnant women in relation
to the value of PAPP-A concentration. The age of pregnant women was not
statistically different in the examined groups (p > 0.05). Conclusion.
Differences in PAPP-A concentration should point out to the obstetrician the
need for more intensive antepartum fetal surveillance in order to increase
the chances of favorable perinatal outcome, regardless gestational age.