Predictive values of maternal serum PAPP-A level, uterine artery Doppler velocimetry, and fetal biometric measurements for poor pregnancy and poor neonatal outcomes in pregnant women.

OBJECTIVE

To determine predictive values of maternal serum PAPP-A (msPAPP-A) levels, uterine artery Doppler velocimetry, and fetal biometric measurements (FBMs) for poor pregnancy and poor neonatal outcomes.

MATERIAL AND METHODS

This prospective cohort study was conducted on singleton pregnancies followed until delivery. Pregnancy and neonatal outcomes were evaluated with respect to the msPAPP-A level at the 11(th)-14(th) weeks, uterine artery Doppler velocimetry at the 15(th)-18(th) weeks, and FBMs at the 20(th)-24(th) and 28(th)-32(nd) weeks of pregnancy.

RESULTS

One hundred fifty-eight women constituted the study group; 17 (10.75%) of them had at least one poor pregnancy outcome. The cut-off point of 0.72 multiple of the median (MoM) for the PAPP-A level achieved a sensitivity of 82.4% and a specificity of 29.8% for poor pregnancy outcomes. The mean birth weight was significantly lower in the subgroup with a higher mean pulsatility index of uterine arteries (UAPImean≥1.19) (p=0.025) as well as in the subgroup with a higher mean resistance index of uterine arteries (UARImean≥0.62) (p=0.013). When the subgroup of pregnant women under the risk of early-onset IUGR according to FBMs was compared to the low-risk group, statistically significant differences were seen in terms of pregnancy outcomes (p=0.045) and birth weight (p=0.011).

CONCLUSION

Maternal serum PAPP-A level and FBMs could be used for predicting pregnancy outcomes, while uterine artery Doppler velocimetry and FBMs could be used for predicting neonatal outcomes, specifically the birth weight.