Hoseini Maryam Sadat, Sheibani Samaneh, Sheikhvatan Mehrdad
Department of Obstetrics and Gynecology, Preventative Gynecology Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran.
Obstet Gynecol Sci. 2020 May;63(3):225-230. doi: 10.5468/ogs.2020.63.3.225. Epub 2020 Apr 16.
Recently, strong evidences were obtained on the association between low pregnancy-associated plasma protein-A (PAPP-A) levels in the first trimester and poor outcomes of pregnancy.
This cross-sectional study was conducted on all pregnant women who were referred to the Obstetrics and Gynecology Clinic at Imam Hossein Hospital in Tehran, Iran in 2014. Women were asked to attend clinical examinations and screening at 11-14 weeks of gestation.
Based on the definition, 14.5% of neonates found to be small for gestational age (SGA). There was a strong association between PAPP-A levels and birth weight. The mean PAPP-A level in the mothers of neonates who were SGA was significantly lower than those without this poor outcome. Based on the receiver operating characteristic curve analysis, serum PAPP-A level was a main determinant in the prediction of SGA neonates.
The serum PAPP-A level at 11-13 weeks of gestation can effectively predict the increased risk for fetal growth retardation. In patients in this study, the best cutoff value for PAPP-A was 0.75 , which signifies that lower levels of this marker can predict fetal growth restriction with high sensitivity and specificity.
最近，关于孕早期妊娠相关血浆蛋白A（PAPP-A）水平低与不良妊娠结局之间的关联已获得有力证据。
这项横断面研究于2014年对所有转诊至伊朗德黑兰伊玛目侯赛因医院妇产科诊所的孕妇进行。要求孕妇在妊娠11-14周时参加临床检查和筛查。
根据定义，14.5%的新生儿被发现小于胎龄（SGA）。PAPP-A水平与出生体重之间存在密切关联。SGA新生儿母亲的平均PAPP-A水平显著低于无此不良结局的新生儿母亲。基于受试者工作特征曲线分析，血清PAPP-A水平是预测SGA新生儿的主要决定因素。
妊娠11-13周时的血清PAPP-A水平可有效预测胎儿生长受限风险增加。在本研究的患者中，PAPP-A的最佳截断值为0.75，这表明该标志物水平较低可高度敏感和特异地预测胎儿生长受限。
