Both Low and High PAPP-A Concentrations in the First Trimester of Pregnancy Are Associated with Increased Risk of Delivery before 32 Weeks in Twin Gestation

• Main Authors: Aleksandra Saletra-Bielińska, Katarzyna Kosińska-Kaczyńska, Iwona Szymusik, Bartosz Kaczyński, Robert Brawura-Biskupski-Samaha, Szymon Kozłowski, Patrycja Jarmużek, Izabela Walasik, Mirosław Wielgoś
• Format: Article
• Language: English
• Published: MDPI AG 2020-07-01
• Series: Journal of Clinical Medicine
• Subjects: preterm delivery; twin pregnancy; pregnancy associated plasma protein; perinatal outcome; intrauterine fetal demise
• Online Access: https://www.mdpi.com/2077-0383/9/7/2099

In twin gestation, the relationship between pregnancy associated plasma protein (PAPPA)<br />and perinatal outcome is unclear. The aim of the study was to determine if low and high<br />concentrations of PAPP-A in the first trimester are related to perinatal outcome in twins. A<br />retrospective study was conducted. Medical data of women in twin pregnancies who delivered<br />between 2013 and 2018 were analyzed. PAPP-A concentrations were measured between 10 + 0 and<br />13 + 6 weeks. The associations between low (<10th percentile) and high (>90th percentile) values of<br />PAPP-A and pregnancy complications were analyzed. A total of 304 patients were included. PAPPA<br /><10th percentile was associated with a high risk of preterm delivery (OR 6.14; 95% CI 2.1–18),<br />delivery <34 weeks (OR 2.39; 95% CI 1.1–5.1) or <32 weeks (OR3.06; 95% CI 1.4–6.8). Significant<br />relations between PAPP-A >90th percentile and delivery <34 weeks (OR4.09; 95% CI 1.8–9.1) or <32<br />weeks (OR 2.83; 95% CI 1.2–6.6) were found. PAPP-A >90th percentile was related to high risk of<br />intrauterine fetal demise (OR 10; 95% CI 2.4–42.5). Both low and high PAPP-A concentrations seem<br />to be related to pregnancy outcome. Further research is needed to investigate evaluation of risk of<br />pregnancy complications according to PAPP-A concentrations as a continuous variable.