Taiwanese Journal of Obstetrics and Gynecology
Volume 46, Issue 3 , Pages 242-247, September 2007

Low Maternal Serum Levels of Pregnancy-associated Plasma Protein-A During the First Trimester are Associated with Subsequent Preterm Delivery with Preterm Premature Rupture of Membranes

  • Bo-Quing She

      Affiliations

    • Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei, Taiwan
    • ,
  • Su-Chee Chen

      Affiliations

    • Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei, Taiwan
    • ,
  • Fa-Kung Lee

      Affiliations

    • Department of Obstetrics and Gynecology, Cathay General Hospital, Hsinchu, Taiwan
    • ,
  • Mei-Leng Cheong

      Affiliations

    • Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei, Taiwan
    • ,
  • Ming-Song Tsai

      Affiliations

    • Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Ming-Song Tsai, Prenatal Diagnosis Center, Department of Obstetrics and Gynecology, Cathay General Hospital, 280 Jen-Ai Road, Section 4, Taipei 106, Taiwan

Accepted 11 December 2006.

Article Outline

Summary 

Objective

To assess the relationship between the first-trimester maternal serum pregnancy-associated plasma protein-A (PAPP-A) levels and pregnancies complicated by preterm delivery.

Materials and Methods

The correlation between PAPP-A levels and gestational age at delivery was analyzed by linear regression. The probabilities of low PAPP-A multiples of the median (MoM) levels between preterm delivery and control population were analyzed by logit model.

Results

A positive correlation was noted between the first-trimester PAPP-A MoM levels and gestational age at delivery between 34–38 weeks (p < 0.001). Lower PAPP-A MoM level had a significantly higher likelihood of preterm delivery (p < 0.05). When preterm premature rupture of membranes (PPROM) and preterm labor (PTL) were analyzed separately, there was an increasing likelihood of PPROM with decreasing PAPP-A MoM levels (p < 0.05), but not for PTL with intact membranes.

Conclusion

Low maternal serum PAPP-A levels during the first trimester may reflect a trophoblast invasion defect in the maternal-fetal interface, resulting in subsequent preterm delivery, particularly in those of PPROM.

Key Words:  pregnancy-associated plasma protein-A , preterm delivery , preterm labor , preterm premature rupture of membranes

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PII: S1028-4559(08)60027-3

doi:10.1016/S1028-4559(08)60027-3

Taiwanese Journal of Obstetrics and Gynecology
Volume 46, Issue 3 , Pages 242-247, September 2007

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