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

Purpose Low levels of plasmatic pregnancy-associated plasma protein-A (PAPP-A) and high levels of free-beta human chorionic gonadotropin (beta-hCG) could influence the outcome of pregnancy. The objective of this study is to assess the correlation between PAPP-A and free beta-hCG and birth weight. Materials and methods Prospective follow-up study performed on 3332 patients in the first trimester of pregnancy who were subjected to a screening test focused on evaluation of fetal aneuploidy (SCA-TEST). The values of PAPP-A and free beta-hCG were both analyzed as raw values and subsequently converted to a multiple of the median (MoM). Statistical analysis was performed using SPSS version 17.0.1 (SPSS Inc., Chicago, USA). Results The incidence of ‘‘small for gestational age’’ in patients with PAPP-A MoM\1st and\5th ‰ was statistically significant (12 and 9.8 %; p<0.0001). Also statistically significant data have been highlighted about free beta MoM [95th ‰ (7 %; p = 0.03). The values of PAPP-A MoM [99th ‰ are significantly correlated with an increased risk of ‘‘large for gestational age’’ (16.7 %; p<0.0001). Conclusion Our study demonstrates that specific values of PAPP-A and free beta-hCG could identify the risk of low or high birth weight since the first trimester of pregnancy.