scholarly journals Pregnancy associated plasma protein A: an early predictor of fetal growth restriction

2021 ◽  
Vol 10 (12) ◽  
pp. 4517
Author(s):  
Pavan Bhargava Chandramohan ◽  
Sarita Agrawal ◽  
Chandrashekhar Shrivastava ◽  
Sarita Rajbhar ◽  
Prasanta Nayak ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Plasma Protein ◽  
Predictive Value ◽  
Fetal Growth Restriction ◽  
Protein A ◽  
Outcome Data ◽  
Adverse Outcomes ◽  
Growth Restriction ◽  
Low Levels ◽  
Sensitivity Specificity

Background: The aim of our study was to determine the association of low levels of pregnancy associated plasma protein-A (PAPP-A) levels estimated at 11-13+6weeks of gestation with fetal growth restriction (FGR).Methods: A prospective observational study of a total of 203 pregnant women with PAPP-A levels were followed up and the outcome data were collected at childbirth.Results: The incidence of FGR was 7.3%. A significant association was found between low levels of PAPP-A MoM (≤0.49) with FGR (p=0.000) with unadjusted odds ratio of 11.6. At PAPP-A multiples of median (MoM) ≤0.49, FGR had a median (Q1, Q3) of 0.46 (0.42, 1.54) versus 1.87 (0.59, 3.11) which was statistically significant (p=0.05) with moderate strength of prediction [minus 0.58 (95% CI, minus 1.113, minus 0.055), p=0.03]. At the cut-off considered in our study i.e., ≤0.49 MoM, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 73%, 81%, 23%, and 97% respectively with a positive LR of 3.82 and negative LR of 0.32. Karl Pearson’s correlation showed positive correlation (r=0.308, p<0.001) between PAPP-A MoM and birthweight and showed that for every unit increase in PAPP-A MoM, birthweight increased by 0.082 times (approximately 90 gm). We also found an association of low PAPP-A with pre-eclampsia, preterm delivery and increased caesarean delivery births.Conclusions: We conclude that low PAPP-A MoM levels are good reflectors of placental function and adverse outcomes. PAPP-A, a part of the dual marker, may be extrapolated for suspecting FGR. This could guide in instituting appropriate feto-maternal surveillance.

Predictive value of pregnancy-associated plasma protein-A (PAPP-A) and free beta-hCG on fetal growth restriction: results of a prospective study

2015 ◽  
Vol 293 (6) ◽  
pp. 1227-1233 ◽  
Author(s):  
Pietro Cignini ◽  
Laura Maggio Savasta ◽  
Ferdinando Antonio Gulino ◽  
Salvatore Giovanni Vitale ◽  
Lucia Mangiafico ◽  
...  
Keyword(s):  
Prospective Study ◽  
Fetal Growth ◽  
Plasma Protein ◽  
Predictive Value ◽  
Fetal Growth Restriction ◽  
Protein A ◽  
Growth Restriction ◽  
Beta Hcg ◽  
A Prospective Study

Pregnancy-associated plasma protein A for prediction of fetal growth restriction

2015 ◽  
Vol 130 (2) ◽  
pp. 200-200 ◽  
Author(s):  
Tsz-kin Lo ◽  
Kelvin Yuen-kwong Chan ◽  
Sario Sau-yuk Chan ◽  
Anita Sik-yau Kan ◽  
Amelia Pui-wah Hui ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Plasma Protein ◽  
Fetal Growth Restriction ◽  
Protein A ◽  
Growth Restriction

scholarly journals Significance of pregnancy-associated plasma protein a (PAPP-a) concentration determination in the assessment of final outcome of pregnancy

2013 ◽  
Vol 70 (1) ◽  
pp. 46-50 ◽  
Author(s):  
Dragan Loncar ◽  
Mirjana Varjacic ◽  
Slobodan Arsenijevic
Keyword(s):  
Pregnant Women ◽  
Fetal Growth ◽  
Plasma Protein ◽  
Gestational Age ◽  
Fetal Growth Restriction ◽  
Protein A ◽  
Growth Restriction ◽  
Control Group ◽  
Group I ◽  
Significant Difference

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.

The role of ultrasound in the prediction of birth weight discordance in twin pregnancies: are we there yet?

2018 ◽  
Vol 46 (2) ◽  
pp. 163-168 ◽  
Author(s):  
Ana Raquel Neves ◽  
Filipa Nunes ◽  
Miguel Branco ◽  
Maria do Céu Almeida ◽  
Isabel Santos Silva
Keyword(s):  
Birth Weight ◽  
Fetal Growth ◽  
Predictive Value ◽  
Fetal Growth Restriction ◽  
Predictive Performance ◽  
Growth Restriction ◽  
Operating Characteristics ◽  
Tertiary Center ◽  
Fetal Malformations ◽  
Twin Pregnancies

AbstractObjective:To analyze the accuracy of ultrasound prediction of birth weight discordance (BWD) and the influence of chorionicity and fetal growth restriction (FGR) on ultrasound performance.Methods:Retrospective analysis of 176 twin pregnancies at a Portuguese tertiary center, between 2008 and 2014. Last ultrasound biometry was recorded. Cases with delivery before 24 weeks, fetal malformations, interval between last ultrasound and deliver >3 weeks, twin-to-twin transfusion syndrome and monoamniotic pregnancies were excluded. The accuracy of prediction of BWD was assessed using the area under the receiver-operating characteristics curve (AUC).Results:BWD ≥20% was present in 21.6% of twin pregnancies. EBW had the best predictive performance for BWD (AUC 0.838, 95%CI 0.760–0.916), with a negative predictive value of 86.9% and a positive predictive value of 51.3%. Chorionicity did not influence ultrasound performance. None of the biometric variables analyzed was predictive of BWD in pregnancies without FGR.Conclusion:The accuracy of ultrasound in the prediction of BWD is limited, particularly in pregnancies without fetal growth restriction. Clinical decisions should not rely on BWD alone.

scholarly journals Metabolomics for predicting fetal growth restriction: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e022743 ◽  
Author(s):  
Debora Farias Batista Leite ◽  
Aude-Claire Morillon ◽  
Elias F Melo Júnior ◽  
Renato T Souza ◽  
Ali S Khashan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Fetal Growth ◽  
Gestational Age ◽  
Fetal Growth Restriction ◽  
Case Reports ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Growth Restriction ◽  
Sample Collection

IntroductionFetal growth restriction (FGR) is a relevant research and clinical concern since it is related to higher risks of adverse outcomes at any period of life. Current predictive tools in pregnancy (clinical factors, ultrasound scan, placenta-related biomarkers) fail to identify the true growth-restricted fetus. However, technologies based on metabolomics have generated interesting findings and seem promising. In this systematic review, we will address diagnostic accuracy of metabolomics analyses in predicting FGR.Methods and analysisOur primary outcome is small for gestational age infant, as a surrogate for FGR, defined as birth weight below the 10th centile by customised or population-based curves for gestational age. A detailed systematic literature search will be carried in electronic databases and conference abstracts, using the keywords ‘fetal growth retardation’, ‘metabolomics’, ‘pregnancy’ and ‘screening’ (and their variations). We will include original peer-reviewed articles published from 1998 to 2018, involving pregnancies of fetuses without congenital malformations; sample collection must have been performed before clinical recognition of growth impairment. If additional information is required, authors will be contacted. Reviews, case reports, cross-sectional studies, non-human research and commentaries papers will be excluded. Sample characteristics and the diagnostic accuracy data will be retrieved and analysed. If data allows, we will perform a meta-analysis.Ethics and disseminationAs this is a systematic review, no ethical approval is necessary. This protocol will be publicised in our institutional websites and results will be submitted for publication in a peer-reviewed journal.PROSPERO registration numberCRD42018089985.

scholarly journals Risk of adverse outcomes for small fetuses not meeting consensus criteria for fetal growth restriction

2022 ◽  
Vol 226 (1) ◽  
pp. S504-S505
Author(s):  
Jennifer E. Powel ◽  
Emily W. Zantow ◽  
Matthew F. Bialko ◽  
Lauren G. Farley ◽  
Tracy M. Tomlinson
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Adverse Outcomes ◽  
Growth Restriction

scholarly journals Evaluation of Placental Perfusion Based on Intravoxel Incoherent Motion Diffusion Weighted Imaging (IVIM-DWI) and Its Predictive Value for Late-Onset Fetal Growth Restriction

2018 ◽  
Vol 79 (04) ◽  
pp. 396-401
Author(s):  
Hui Shi ◽  
Xianyue Quan ◽  
Wen Liang ◽  
Xinming Li ◽  
Bin Ai ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Predictive Value ◽  
Fetal Growth Restriction ◽  
Diffusion Weighted Imaging ◽  
Uterine Artery ◽  
Late Onset ◽  
Late Pregnancy ◽  
Growth Restriction ◽  
Placental Perfusion ◽  
Perfusion Fraction

Abstract Objective The aim of this study was to investigate placental blood perfusion in middle and late pregnancy and explore its predictive value for fetal growth restriction (FGR). Methods All pregnant women included in the study were examined using placental intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI). Three IVIM parameters (D, f, D*) were obtained for each pregnant woman and analyzed using Image J software. Perfusion fraction f is a radiological marker of placental perfusion. The pulsatility index (PI) of the uterine artery is used to indirectly evaluate placental function. Results f-values were significantly lower in the late-onset FGR group compared to the normal late pregnancy group (19.07 vs. 27.78%). In addition, uterine artery PI values were markedly increased in the late-onset FGR group compared to the normal late pregnancy group (1.96 vs. 1.03), and neonatal weight was significantly lower in the late-onset FGR group (2.75 vs. 3.18 kg). There was a significant positive correlation between f-value, uterine artery PI and neonatal weight (r = 0.968, p < 0.01; r = 0.959, p < 0.01). There was a significant negative correlation between f-value and age of gestation (r = − 0.534, p < 0.01). Conclusion Perfusion fraction f was strongly correlated with uterine artery blood flow resistance as measured by color Doppler and had a certain predictive value for late-onset FGR.

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