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Deutsches Institut für Urbanistik
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Walter de Gruyter
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Zehra Nese Kavak, Alin Basgul, Koray Elter, Meltem Uygur, Husnu Gokaslan

The efficacy of first-trimester PAPP-A and free ?hCG levels for predicting adverse pregnancy outcome

Keywords: diabetes, hCG, PAPP-A, preeclampsia, pregnancy outcome, screening, SGA

Objective: To determine whether first-trimester measurements of maternal serum PAPP-A and free ?hCG levels were associated with adverse pregnancy outcomes.

Study Design: First trimester maternal serum free ?hCG and PAPP-A were measured in 490 singleton pregnancies. Pregnancies were followed by the fetal-maternal unit, and predictive efficacy of these markers for small for gestational age (SGA) babies, gestational diabetes mellitus and hypertensive disorders were analyzed by cut-off values determined by using a ROC analysis, and also, by using the fifth percentile as the cut-off value.

Results: The sensitivities for PAPP-A in predicting pregnancies with a SGA baby and those complicated by a hypertensive disorder were 49% and 73%, respectively, when optimal cut-off values were used. Specificities were 76% and 65%, respectively. Serum free ?hCG had no predictive value for individual pregnancy outcomes.

Conclusion: Efficacy of first trimester maternal serum markers in predicting adverse pregnancy outcome is low. Even after optimization of cut-off values, these markers do not appear to be clinically acceptable as an effective tool for screening for adverse pregnancy outcomes.

Journal of Perinatal Medicine, Walter de Gruyter

Print ISSN: 1619-3997
Volume: 34, 04/2006
Pages: 145 - 148

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