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Does first‐trimester serum pregnancy‐associated plasma protein A differ in pregnant women with sickle cell disease?
Author(s) -
Peeva Gergana,
Oakley Laura,
Rège Inez,
Nicolaides Kypros,
OtengNtim Eugene
Publication year - 2019
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.5507
Subject(s) - pregnancy associated plasma protein a , interquartile range , medicine , incidence (geometry) , pregnancy , obstetrics , gestational age , genotype , small for gestational age , gestation , first trimester , biology , biochemistry , physics , gene , optics , genetics
Objective To assess whether levels of first‐trimester pregnancy‐associated plasma protein A (PAPP‐A) differ between women with and without sickle cell disease (SCD). Methods Retrospective study of 101 singleton pregnancies in women with SCD (including 55 with genotype HbSS, 37 with genotype HbSC, and nine with other genotypes). Measured levels of PAPP‐A were converted to multiple of the median (MoM) values corrected for gestational age and maternal characteristics. Median PAPP‐A MoM in the SCD group was compared with that of 1010 controls. Results In the SCD group median, PAPP‐A MoM was lower than in the non‐SCD group (0.72, interquartile range [IQR] = 0.54‐1.14 versus 1.09, IQR = 0.74‐1.49; P < .001). Within the SCD group median PAPP‐A MoM was lower for those with genotype HbSS than HbSC (0.62, IQR = 0.44‐1.14 versus 0.94, IQR = 0.72‐1.25; .006). In 7.3% (4/55) of the HbSS group, there was stillbirth, and in these cases, PAPP‐A was less than or equal to 0.5 MoM; in the control group, the incidence of stillbirth was lower (1%; P < .001). In HbSS disease, the incidence of small for gestational age (SGA) neonates was increased. Conclusion Pregnancies with HbSS have lower PAPP‐A MoM values and higher incidence of stillbirth and birth of SGA neonates than in non‐SCD controls.