Ministry of Health Ankara Bilkent City Hospital, Ankara, Turkey.
Department of Obstetrics and Gynecology, Istanbul University Cerrahpaşa School of Medicine, Istanbul, Turkey.
J Neonatal Perinatal Med. 2022;15(1):123-128. doi: 10.3233/NPM-200560.
Low values of pregnancy associated plasma protein A (PAPP-A), have been shown to be associated with some poor gestational outcomes, especially those related to placental deficiency such as pre-eclampsia and fetal growth restriction as well as preterm labor. The aim of this study was to compare first trimester PAPP-A MoM values with the surfactant needs of newborns of pregnant women who had a preterm delivery.
This study included 216 pregnant women who had a preterm delivery, who were found to be in the low-risk group based on their aneuploidy screening. The women were separated into two groups based on the surfactant receipts of their newborns. A record was made of the obstetric history, birth characteristics of the preterm infants, and whether or not there was a need for surfactant.
A comparison of the PAPP-A values of the two groups revealed that the group that received surfactant had statistically significantly lower PAPP-A values (t(-3.97) = 0.203, p < 0.001). When the cut-off value of PAPP-A was taken as 1 MoM and the gestational age was analyzed together with the birth weight, PAPP-A alone was found to be a significant independent variable for the prediction of respiratory distress syndrome (RDS) (p = 0.031; OR:8.2 (1.2-55.6)).
The result of this study demonstrated that PAPP-A MoM values may be significant in predicting the need for surfactant in RDS, which is a frequently seen condition in the neonatal period.
低水平的妊娠相关血浆蛋白 A（PAPP-A）与一些不良妊娠结局相关，尤其是与胎盘功能不全相关的结局，如子痫前期和胎儿生长受限以及早产。本研究的目的是比较早孕期 PAPP-A MoM 值与早产儿肺表面活性物质需求的关系。
本研究纳入了 216 例因早产而接受剖宫产分娩的低危孕妇。根据其非整倍体筛查结果将孕妇分为两组。记录孕妇的产科病史、早产儿的出生特征、是否需要肺表面活性物质。
两组 PAPP-A 值比较，发现需要肺表面活性物质的组 PAPP-A 值明显降低（t（-3.97）=0.203，p<0.001）。当 PAPP-A 截断值为 1 MoM 时，与出生体重一起分析，发现 PAPP-A 是预测呼吸窘迫综合征（RDS）的显著独立变量（p=0.031；OR：8.2（1.2-55.6））。
本研究结果表明，PAPP-A MoM 值在预测 RDS 中肺表面活性物质的需求方面可能具有重要意义，RDS 是新生儿期常见的疾病。
