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Pregnancy‐associated plasma protein A levels and neonatal complications in post‐date pregnancies
Author(s) -
Zizzo Anne R.,
Kirkegaard Ida,
Henriksen Tine B.,
Ulbjerg Niels
Publication year - 2013
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.4174
Subject(s) - medicine , obstetrics , pregnancy , gestation , pregnancy associated plasma protein a , apgar score , gestational age , neonatal intensive care unit , neonatology , first trimester , small for gestational age , gynecology , pediatrics , biology , genetics
Objectives To assess the association between serum pregnancy‐associated plasma protein A (PAPP‐A) and free β‐human chorionic gonadotropin (free β‐hCG) in the first trimester and perinatal complications in post‐date pregnancies. Methods A total of 4948 women, who delivered after 40 gestational weeks, were included. Labour was not induced routinely until 42 weeks. Serum levels of PAPP‐A and free β‐hCG were determined at the first‐trimester screening for Down syndrome. Neonatal complications were obtained from specific registration forms filled out by senior neonatologists. Results In post‐date pregnancies, PAPP‐A < 0.4 multiples of the median was associated with Apgar score of less than 7 at 5 min (OR adj 5.4, 95% CI 2.0–14.3), admission to the neonatal intensive care unit (OR adj 1.5, 95% CI 1.0–2.3) and newborn hypoglycaemia (OR adj 3.4, 95% CI 1.8–6.4). In small for gestation (SGA) neonates, the risk of hypoglycaemia was further increased (OR 14.6, 95% CI 3.4–58.0). Similar analyses were made with free β‐hCG, but no statistically significant associations were found. Conclusions Low first‐trimester serum PAPP‐A was associated with increased neonatal morbidity in post‐date pregnancies, particularly in newborns with SGA. Thus, PAPP‐A may qualify the timing of induction of labour in these pregnancies. © 2013 John Wiley & Sons, Ltd.