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Low First Trimester Pregnancy-Associated Plasma Protein-A Levels Are Not Associated with an Increased Risk of Intrapartum Fetal Compromise or Adverse Neonatal Outcomes: A Retrospective Cohort Study
- Source :
- Journal of Clinical Medicine, Volume 9, Issue 4, Journal of Clinical Medicine, Vol 9, Iss 1108, p 1108 (2020)
- Publication Year :
- 2020
- Publisher :
- Multidisciplinary Digital Publishing Institute, 2020.
-
Abstract
- The aim of this study was to assess if women with a low first trimester maternal pregnancy-associated plasma protein-A (PAPP-A) level are at increased risk of emergency cesarean (EmCS) for intrapartum fetal compromise (IFC) and/or adverse neonatal outcomes. This was a retrospective cohort study performed at Mater Mother&rsquo<br />s Hospital, Brisbane, Australia, between 2016 and 2018. All women with a singleton, euploid, non-anomalous fetus with a documented PAPP-A level measured between 10 +0 and 13 +6 weeks gestation during the study period were included. Data were extracted from the institution&rsquo<br />s perinatal database and dichotomized according to PAPP-A level (&le<br />0.4 Multiples of Medium (MoM) vs. &gt<br />0.4 MoM). The primary outcomes were EmCS-IFC and a composite of severe adverse neonatal outcomes (SCNO). Nine thousand sixty-one pregnancies were included, 3.3% with a PAPP-A &le<br />0.4 MoM. Low maternal PAPP-A was not associated with an increased risk of EmCS-IFC (adjusted odds ratio (aOR) 0.77, 95% confidence interval (CI) 0.24&ndash<br />2.46, p = 0.66) or SCNO (aOR 0.65, 95% CI 0.39&ndash<br />1.07, p = 0.09). Low PAPP-A was associated with increased odds of pre-eclampsia, preterm birth and birthweight &lt<br />10th centile. In conclusion, low maternal PAPP-A level is not associated with an increased risk of EmCS IFC or adverse neonatal outcomes despite greater odds of low-birthweight infants and preterm birth.
- Subjects :
- medicine.medical_specialty
lcsh:Medicine
Article
Odds
03 medical and health sciences
0302 clinical medicine
biochemical markers
fetal compromise
adverse perinatal outcomes
medicine
030212 general & internal medicine
reproductive and urinary physiology
Fetus
030219 obstetrics & reproductive medicine
emergency cesarean birth
Obstetrics
business.industry
lcsh:R
Retrospective cohort study
General Medicine
Odds ratio
Blood proteins
Confidence interval
Gestation
Biomarker (medicine)
biomarker
PAPP-A
business
Subjects
Details
- Language :
- English
- ISSN :
- 20770383
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Medicine
- Accession number :
- edsair.doi.dedup.....842cd968da1df51ec5c0412159996a8f
- Full Text :
- https://doi.org/10.3390/jcm9041108