Association of maternal serum PAPP-A levels, nuchal translucency and crown–rump length in first trimester with adverse pregnancy outcomes:: retrospective cohort study

Ashwini Bilagi; Danielle L. Burke; Richard D. Riley; Ian Mills; Mark D. Kilby; R. Katie Morris

doi:10.1002/pd.5069

Association of maternal serum PAPP-A levels, nuchal translucency and crown–rump length in first trimester with adverse pregnancy outcomes: retrospective cohort study

Ashwini Bilagi, Danielle L. Burke, Richard D. Riley, Ian Mills, Mark D. Kilby, R. Katie Morris^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

182 Downloads (Pure)

Abstract

Objective: Are first trimester serum pregnancy-associated plasma protein-A (PAPP-A), nuchal translucency (NT) and crown–rump length (CRL) prognostic factors for adverse pregnancy outcomes?.

Method: Retrospective cohort, women, singleton pregnancies (UK 2011–2015). Unadjusted and multivariable logistic regression. Outcomes: small for gestational age (SGA), pre-eclampsia (PE), preterm birth (PTB), miscarriage, stillbirth, perinatal mortality and neonatal death (NND).

Results: A total of 12 592 pregnancies: 852 (6.8%) PTB, 352 (2.8%) PE, 1824 (14.5%) SGA, 73 (0.6%) miscarriages, 37(0.3%) stillbirths, 73 perinatal deaths (0.6%) and 38 (0.30%) NND. Multivariable analysis: lower odds of SGA [adjusted odds ratio (aOR) 0.88 (95% CI 0.85,0.91)], PTB [0.92 (95%CI 0.88,0.97)], PE [0.91 (95% CI 0.85,0.97)] and stillbirth [0.71 (95% CI 0.52,0.98)] as PAPP-A increases. Lower odds of SGA [aOR 0.79 (95% CI 0.70,0.89)] but higher odds of miscarriage [aOR 1.75 95% CI (1.12,2.72)] as NT increases, and lower odds of stillbirth as CRL increases [aOR 0.94 95% CI (0.89,0.99)]. Multivariable analysis of three factors together demonstrated strong associations: a) PAPP-A, NT, CRL and SGA, b) PAPP-A and PTB, c) PAPP-A, CRL and PE, d) NT and miscarriage. Conclusions: Pregnancy-associated plasma protein-A, NT and CRL are independent prognostic factors for adverse pregnancy outcomes, particularly PAPP-A and SGA with lower PAPP-A associated with increased risk.

Original language	English
Pages (from-to)	705-711
Number of pages	7
Journal	Prenatal Diagnosis
Volume	37
Issue number	7
Early online date	16 Jun 2017
DOIs	https://doi.org/10.1002/pd.5069
Publication status	Published - Jul 2017

ASJC Scopus subject areas

Obstetrics and Gynaecology
Genetics(clinical)

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Bilagi_et_al_Association_of_maternal_serum_Parental_Diagnosis_2017
This is the peer reviewed version of the following article:Bilagi, A., Burke, D. L., Riley, R. D., Mills, I., Kilby, M. D., and Katie Morris, R. (2017) Association of maternal serum PAPP-A levels, nuchal translucency and crown–rump length in first trimester with adverse pregnancy outcomes: retrospective cohort study. Prenat Diagn, 37: 705–711. doi: 10.1002/pd.5069, which has been published in final form at 10.1002/pd.5069. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Accepted author manuscript, 262 KBLicence: Other (please specify with Rights Statement)

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Cite this

@article{90964143e60a4c9993b4e4cdd073c2b4,

title = "Association of maternal serum PAPP-A levels, nuchal translucency and crown–rump length in first trimester with adverse pregnancy outcomes:: retrospective cohort study",

abstract = "Objective: Are first trimester serum pregnancy-associated plasma protein-A (PAPP-A), nuchal translucency (NT) and crown–rump length (CRL) prognostic factors for adverse pregnancy outcomes?. Method: Retrospective cohort, women, singleton pregnancies (UK 2011–2015). Unadjusted and multivariable logistic regression. Outcomes: small for gestational age (SGA), pre-eclampsia (PE), preterm birth (PTB), miscarriage, stillbirth, perinatal mortality and neonatal death (NND). Results: A total of 12 592 pregnancies: 852 (6.8%) PTB, 352 (2.8%) PE, 1824 (14.5%) SGA, 73 (0.6%) miscarriages, 37(0.3%) stillbirths, 73 perinatal deaths (0.6%) and 38 (0.30%) NND. Multivariable analysis: lower odds of SGA [adjusted odds ratio (aOR) 0.88 (95% CI 0.85,0.91)], PTB [0.92 (95%CI 0.88,0.97)], PE [0.91 (95% CI 0.85,0.97)] and stillbirth [0.71 (95% CI 0.52,0.98)] as PAPP-A increases. Lower odds of SGA [aOR 0.79 (95% CI 0.70,0.89)] but higher odds of miscarriage [aOR 1.75 95% CI (1.12,2.72)] as NT increases, and lower odds of stillbirth as CRL increases [aOR 0.94 95% CI (0.89,0.99)]. Multivariable analysis of three factors together demonstrated strong associations: a) PAPP-A, NT, CRL and SGA, b) PAPP-A and PTB, c) PAPP-A, CRL and PE, d) NT and miscarriage. Conclusions: Pregnancy-associated plasma protein-A, NT and CRL are independent prognostic factors for adverse pregnancy outcomes, particularly PAPP-A and SGA with lower PAPP-A associated with increased risk.",

author = "Ashwini Bilagi and Burke, {Danielle L.} and Riley, {Richard D.} and Ian Mills and Kilby, {Mark D.} and {Katie Morris}, R.",

year = "2017",

month = jul,

doi = "10.1002/pd.5069",

language = "English",

volume = "37",

pages = "705--711",

journal = "Prenatal Diagnosis",

issn = "0197-3851",

publisher = "Wiley",

number = "7",

}

TY - JOUR

T1 - Association of maternal serum PAPP-A levels, nuchal translucency and crown–rump length in first trimester with adverse pregnancy outcomes:

T2 - retrospective cohort study

AU - Bilagi, Ashwini

AU - Burke, Danielle L.

AU - Riley, Richard D.

AU - Mills, Ian

AU - Kilby, Mark D.

AU - Katie Morris, R.

PY - 2017/7

Y1 - 2017/7

N2 - Objective: Are first trimester serum pregnancy-associated plasma protein-A (PAPP-A), nuchal translucency (NT) and crown–rump length (CRL) prognostic factors for adverse pregnancy outcomes?. Method: Retrospective cohort, women, singleton pregnancies (UK 2011–2015). Unadjusted and multivariable logistic regression. Outcomes: small for gestational age (SGA), pre-eclampsia (PE), preterm birth (PTB), miscarriage, stillbirth, perinatal mortality and neonatal death (NND). Results: A total of 12 592 pregnancies: 852 (6.8%) PTB, 352 (2.8%) PE, 1824 (14.5%) SGA, 73 (0.6%) miscarriages, 37(0.3%) stillbirths, 73 perinatal deaths (0.6%) and 38 (0.30%) NND. Multivariable analysis: lower odds of SGA [adjusted odds ratio (aOR) 0.88 (95% CI 0.85,0.91)], PTB [0.92 (95%CI 0.88,0.97)], PE [0.91 (95% CI 0.85,0.97)] and stillbirth [0.71 (95% CI 0.52,0.98)] as PAPP-A increases. Lower odds of SGA [aOR 0.79 (95% CI 0.70,0.89)] but higher odds of miscarriage [aOR 1.75 95% CI (1.12,2.72)] as NT increases, and lower odds of stillbirth as CRL increases [aOR 0.94 95% CI (0.89,0.99)]. Multivariable analysis of three factors together demonstrated strong associations: a) PAPP-A, NT, CRL and SGA, b) PAPP-A and PTB, c) PAPP-A, CRL and PE, d) NT and miscarriage. Conclusions: Pregnancy-associated plasma protein-A, NT and CRL are independent prognostic factors for adverse pregnancy outcomes, particularly PAPP-A and SGA with lower PAPP-A associated with increased risk.

AB - Objective: Are first trimester serum pregnancy-associated plasma protein-A (PAPP-A), nuchal translucency (NT) and crown–rump length (CRL) prognostic factors for adverse pregnancy outcomes?. Method: Retrospective cohort, women, singleton pregnancies (UK 2011–2015). Unadjusted and multivariable logistic regression. Outcomes: small for gestational age (SGA), pre-eclampsia (PE), preterm birth (PTB), miscarriage, stillbirth, perinatal mortality and neonatal death (NND). Results: A total of 12 592 pregnancies: 852 (6.8%) PTB, 352 (2.8%) PE, 1824 (14.5%) SGA, 73 (0.6%) miscarriages, 37(0.3%) stillbirths, 73 perinatal deaths (0.6%) and 38 (0.30%) NND. Multivariable analysis: lower odds of SGA [adjusted odds ratio (aOR) 0.88 (95% CI 0.85,0.91)], PTB [0.92 (95%CI 0.88,0.97)], PE [0.91 (95% CI 0.85,0.97)] and stillbirth [0.71 (95% CI 0.52,0.98)] as PAPP-A increases. Lower odds of SGA [aOR 0.79 (95% CI 0.70,0.89)] but higher odds of miscarriage [aOR 1.75 95% CI (1.12,2.72)] as NT increases, and lower odds of stillbirth as CRL increases [aOR 0.94 95% CI (0.89,0.99)]. Multivariable analysis of three factors together demonstrated strong associations: a) PAPP-A, NT, CRL and SGA, b) PAPP-A and PTB, c) PAPP-A, CRL and PE, d) NT and miscarriage. Conclusions: Pregnancy-associated plasma protein-A, NT and CRL are independent prognostic factors for adverse pregnancy outcomes, particularly PAPP-A and SGA with lower PAPP-A associated with increased risk.

U2 - 10.1002/pd.5069

DO - 10.1002/pd.5069

M3 - Article

AN - SCOPUS:85021704239

SN - 0197-3851

VL - 37

SP - 705

EP - 711

JO - Prenatal Diagnosis

JF - Prenatal Diagnosis

IS - 7

ER -

Association of maternal serum PAPP-A levels, nuchal translucency and crown–rump length in first trimester with adverse pregnancy outcomes: retrospective cohort study

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