Analysis of the Effectiveness of First Trimester Nucal Translucence, Free Beta-Human Chorionic Gonadotropin, and Pregnancy-Related Plasma Protein-A in Prediction of Pregnancy Complications

Year 2022, Volume: 5 Issue: 3, 533 - 539, 01.09.2022

Kamuran Suman , Zafer Bütün , Musa Büyük , Murat Suman , Banu Dane

https://doi.org/10.19127/bshealthscience.1089239

Abstract

In this study, we aimed to investigate whether there was an association between fetal nuchal translucency (NT) and the serum markers plasma protein-A (PAPP-A) and free beta-human chorionic gonadotropin (β-hCG) measured by the first-trimester screening test, as well as birth weight and hypertension. 454 pregnant women who had undergone the first-trimester screening test for Down syndrome were included in the study. All measurements and values of NT, PAPP-A and β-hCG levels were performed between gestational weeks 11-14. Values of PAPP-A and β-hCG converted to multiples of the corrected median (MoM) were obtained using the PRISCA software package. Regarding the prediction of SGA infants, when the PAPP-A value < was 0.99MoM as a threshold, and when the free β-hCG value < was 0.69 MoM, SGA cases could be detected with a sensitivity of 83% and a specificity of 71.9%. Regarding the prediction of hypertension, at a threshold PAPP-A value of

Keywords

First trimester, NT, PAPP-A, β-hCG, Birth weight, Preeclampsia

References

• Alexandra B, Panaitescu AM, Nicolaides KH. 2022. First trimester prediction of adverse pregnancy outcomes-identifying pregnancies at risk from as early as 11–13 weeks. Medicina, 58: 332.
• Amélie B, Gasse C, Demers S, Blanchet G, Giguère Y, Bujold E. 2018. Does low PAPP-A predict adverse placenta-mediated outcomes in a low-risk nulliparous population? The great obstetrical syndromes (GOS) study. J Obstet Gynaecol Canada, 40: 663-668.
• Bhargava CP, Agrawal S, Shrivastava C, Rajbhar S, Nayak P, Singh V. 2021. Pregnancy associated plasma protein A: an early predictor of fetal growth restriction. Inter J Reprod, Contracept, Obstet Gynecol, 10: 4517-4522.
• Espid M, Davati A, Garshasbi A. 2021. The relationship between pregnancy associated-plasma-protein-A (PAPP-A) and free-β-human chorionic gonadotropin (βhCG) levels in the first trimester and pregnancy complications. Daneshvar Med, 29: 1-13.
• Hendrix MLE, Bons JAP, Snellings RRG, Bekers O, van Kuijk SMJ, Spaanderman MEA, Al-Nasiry S. 2019. Can fetal growth velocity and first trimester maternal biomarkers improve the prediction of small-for-gestational age and adverse neonatal outcome? Fetal Diag Therap, 46: 274-284.
• Hendrix MLE, Bons JAP, Snellings RRG, Bekers O, van Kuijk SMJ, Spaanderman MEA, Al-Nasiry S. 2021. Improve the prediction of SGA and adverse neonatal outcome? Fetal growth Restrict, 46: 43.
• Honarjoo M, Zarean E, Tarrahi MJ, Kohan S. 2021. Role of pregnancy-associated plasma protein A (PAPP-A) and human-derived chorionic gonadotrophic hormone (free β-hCG) serum levels as a marker in predicting of Small for gestational age (SGA): A cohort study. J Res Med Sci, 1: 26.
• Hoseini MS, Sheibani S, Sheikhvatan M. 2020. The evaluating of pregnancy-associated plasma protein-A with the likelihood of small for gestational age. Obstet Gynecol Sci, 63: 225-230.
• Hu J, Zhang J, He G, Zhu S, Tang X, Su J, Li Q, Kong Y, Zhu B. 2020. First-trimester maternal serum alpha-fetoprotein is not a good predictor for adverse pregnancy outcomes: a retrospective study of 3325 cases. BMC Pregnan Childbirth, 20: 1-8.
• Hughes AE, Sovio U, Gaccioli F, Cook E, Charnock-Jones DS, Smith GCS. 2019. The association between first trimester AFP to PAPP-A ratio and placentally-related adverse pregnancy outcome. Placenta, 81: 25-31.
• Kapustin RV, Kascheeva TK, Alekseenkova EN, Shelaeva EV. 2022. Are the first-trimester levels of PAPP-A and fb-hCG predictors for obstetrical complications in diabetic pregnancy? J Mater Fetal Neonat Med, 35: 1113-1119.
• Katarzyna Z, Dydowicz P, Sobkowski M, Tobola-Wrobel K, Wysocka E, Pietryga M. 2019. The clinical usefulness of biochemical (free β-hCg, PaPP-a) and ultrasound (nuchal translucency) parameters in prenatal screening of trisomy 21 in the first trimester of pregnancy. Ginekol Polska, 90: 161-166.
• Kim YR, Park G, Joo EH, Jang JH, Ahn EH, Jung SH, Jung I, Cho HY. 2021. First-trimester screening model for small-for-gestational-age using maternal clinical characteristics, serum screening markers, and placental volume: prospective cohort study J Mater Fetal Neonat Med, 34: 1-6.
• Krupa SH, Anjum A, Nair P, Bhat P, Bhat RG, Bhat S. 2020. Pregnancy associated plasma protein A: An indicator of adverse obstetric outcomes in a South India population. Turkish J Obstet Gynecol, 17: 40.
• Livrinova V, Petrov I, Samardziski I, Jovanovska V, Boshku AA, Todorovska I, Dabeski D, Shabani A. 2019. Clinical importance of low level of PAPP-A in first trimester of pregnancy-an obstetrical dilemma in chromosomally normal fetus. Macedonian J Med Sci, 7: 1475.
• Livrinova V, Petrov I, Samardziski I, Jovanovska V, Simeonova-Krstevska S, Todorovska I, Atanasova-Boshku A, Gjeorgjievska M. 2018. Obstetric outcome in pregnant patients with low level of pregnancy-associated plasma protein A in first trimester. Macedonian J Med Sci, 6: 1028.
• Noël L, Guy GP, Jones S, Forenc K, Buck E, Papageorghiou AT, Thilaganathan B. 2021. Routine first‐trimester combined screening for pre‐eclampsia: pregnancy‐associated plasma protein‐A or placental growth factor? Ultrasound Obstet Gynecol, 58: 540-545.
• Papastefanou I, Wright D, Syngelaki A, Souretis K, Chrysanthopoulou E, Nicolaides KH. 2021. Competing‐risks model for prediction of small‐for‐gestational‐age neonate from biophysical and biochemical markers at 11–13 weeks' gestation. Ultrasound Obstet Gynecol, 57: 52-61.
• Peña DP, Savirón-Cornudella R, Tajada-Duaso M, Pérez-López FR, Castán-Mateo S, Sanz G, Esteban LM. 2022. Personalized Model to predict small for gestational age at delivery using fetal biometrics, maternal characteristics, and pregnancy biomarkers: a retrospective cohort study of births assisted at a Spanish hospital. J Personal Med, 12: 762.
• Rathakrishnan GS. 2022. Serum PAPP-A and maternal risk factors in prediction of SGA: A retrospective study. Inter J Infert Fetal Med, 13(2): 52-55.
• Voicu D, Furau G, Pilat L, Onel C, Puschita M. 2020. Screening for hypertensive pregnancy complications through maternal serum PAPP-A 5th and 10th percentiles during the 11-14 weeks gestational age interval. Revista de Chimie, 71: 262-266.