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Abstract

PREVALENCE AND PROPERTIES OF PREGNANT WOMEN WITH LOW PREGNANCY ASSOCIATED PLASMA PROTEIN A (PAPP-A) IN THE FIRST TRIMESTER SCREENING

Zeinab Zamanpur, Mojgan Barati,*Razieh Mohamad Jafari , Sara Masihi, Najmieh Saadati

ABSTRACT

Background and Aims: Pregnancy associated plasma protein A (PAPP-A) is a large glycoprotein which is produced by the placenta and deciduas. It is supposed that PAPP-A serves to prevent the recognition of the fetus by the maternal immune system. The aims of the present study were to evaluate the prevalence of low PAPP-A in the first trimester among screened population of pregnant women as well as their properties. Materials and Methods: This retrospective medical record reviews study was performed on the 137 singleton pregnant women with PAPP-A<0.4 MOM in Imam Khomeini Hospital (a tertiary, general and teaching hospital, Ahvaz, Iran between Sep 2011 to Sep 2013. At this time period, of 8703 women who underwent the first trimester screening, 137 had low PAPP-A (less than 0.4 MoM). Anonymous and confidentiality were guaranteed. Characteristics and clinical information were collected by one trained abstractor. Results: 137from 8703 (1.57%) were mothers with PAPPA <0.4. The mean scores for maternal age and weight were 29.84 ± 5.5 years and 68.97 ± 12.41 kg, respectively. 44% were nullipara. Adjusted risk for trisomy 13 and 18 was significantly higher than background risk in mothers with PAPP-A<0.4, while this difference for trisomy 21 was not significant. Conclusion: The goal of our study was not to assess relationship between low PAPP-A and SGA which has been previously proven. Becuase in our region, mothers with low PAPP-A are not considered properly and missed undiagnosed; therefore our goal was to report and describe properties of this group of pregnant women. We should more attention to pregant women to prevent and decrease adverse subsequnets which are resulted from low PAPP-A (<0.4 MoM).

Keywords: Pregnancy associated plasma protein A (PAPP-A), first trimester screening


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