Efficiency of first-trimester growth restriction and low pregnancy-associated plasma protein-A in predicting small for gestational age at delivery

Prenatal Diagnosis
Jeanine F CarboneAnthony O Odibo

Abstract

To evaluate the efficiency of first-trimester fetal growth restriction (FGR), low pregnancy-associated plasma protein A (PAPP-A), and their combination for predicting small for gestational age (SGA) at delivery. Retrospective cohort study of women undergoing first-trimester aneuploidy screening. Fetal crown-rump lengths (CRLs) were at 10 to 14 weeks' gestation and converted to gestational age adjusted Z-scores. Low PAPP-A was defined as levels<5th percentile for GA. Receiver-operating characteristic curves were used to assess screening efficiencies. Among 3269 pregnancies meeting the inclusion criteria 185 (5.7%) infants were SGA. CRL Z-score< -1.0 standard deviation was identified as the optimal definition of early FGR. Using either CRL Z-score< -1.0 standard deviation or PAPP-A<5th percentile had the highest sensitivity (33%) with a specificity of 82.1% when screening for SGA. Using a combination resulted in an increased association (adjusted odds ratio 4.23[confidence interval 1.37-13.03]) at the expense of significantly reduced sensitivity (3.13%). First-trimester FGR and PAPP-A<5th percentile are associated with delivery of an SGA infant. Neither of these parameters or the combination of the two are sufficient powerful pre...Continue Reading

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Citations

Mar 28, 2013·Health and Quality of Life Outcomes·Afra van LunenburgGijsbert H W Verrips
Feb 6, 2014·Archives of Gynecology and Obstetrics·Markus HoopmannKarl Oliver Kagan
Apr 5, 2013·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·C O'ConnorM M Kennelly
Jan 1, 2014·Journal of Clinical Medicine·David KrantzJonathan Carmichael
Jan 24, 2015·Statistics in Medicine·Sten P WillemsenEmmanuel Lesaffre
May 9, 2014·Prenatal Diagnosis·Andrew N Sharp, Zarko Alfirevic
May 20, 2014·American Journal of Obstetrics and Gynecology·Mara RosnerJuliana Gebb
Jun 4, 2020·Obstetrics & Gynecology Science·Maryam Sadat HoseiniMehrdad Sheikhvatan
May 4, 2021·Journal of Neonatal-perinatal Medicine·B YakiştiranF E Canpolat

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