Volume 14, Issue 6 (6-2016)                   IJRM 2016, 14(6): 421-426 | Back to browse issues page

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Mesdaghi-nia E, Behrashi M, Saeidi A, Abedzadeh Kalahroodi M. Association between PAPP-A and placental thickness. IJRM 2016; 14 (6) :421-426
URL: http://ijrm.ir/article-1-755-en.html
Association between PAPP-A and placental thickness
Elaheh Mesdaghi-nia1 , Mitra Behrashi1 , Arezoo Saeidi * 2, Masoomeh Abedzadeh Kalahroodi3
1- Kashan University of Medical Sciences, Kashan, Iran
2- Kashan University of Medical Sciences, Kashan, Iran , Saeidi.arezoo62@gmail.com
3- Truma Medical Center, Kashan University of Medical Sciences, Kashan, Iran
Abstract:   (2348 Views)
Background: Measuring of maternal serum pregnancy-associated plasma protein-A (PAPP-A) in first trimester can be a way for early detection of adverse prenatal outcome due to faulty placenta.
Objective: The aim was to Determination of association between placental thickness in second trimester with low level of PAPP-A in first trimester.
Materials and Methods: In this cohort study, serum PAPP-A of 187 pregnant women was measured in the first trimester of pregnancy. Patients who had PAPP-A ≤0.8 MOM were in exposed and others who had PAPP-A >0.8 defined as unexposed group. The criteria of placental thickness in ultrasound study was thickness of 4 cm or more than 50% of placental length.
Results: Of 187 patients, 87 patients had PAPP-A >0.8 and 93 patients had PAPP-A ≤0.8. Women with low levels of PAPP-A in the first trimester, had an increased incidence placental thickness of 34.4%, whereas another group had about 15% (p=0.002). Also, PAPP-A levels had acceptable sensitivity and specificity for placental thickness detection (71.1% and 54.8%, respectively.
Conclusion: Our study showed that serum level of PAPP-A generally was low (≤0.8) in women with a thick placenta (>4 cm or >50% of placental length). The first trimester of pregnancy measurement of PAPP-A will be more predictable for healthy placenta.
Keywords: Pregnancy-associated plasma protein-A (PAPP-A), Pregnancy, Placenta
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Type of Study: Original Article |
References
1. Guibourdenche J, Frendo JL, Pidoux G, Bertin G, Luton D, Muller F, et al. Expression of pregnancyassociated plasma protein-A (PAPP-A) during human villous trophoblast differentiation in vitro. Placenta 2003; 24: 532-539. [DOI:10.1053/plac.2002.0944]
2. Overgaard MT, Oxvig C, Christiansen M, Lawrence JB, Conover CA, Gleich GJ, et al. Messenger ribonucleic acid levels of pregnancy-associated plasma protein-A and the proform of eosinophil major basic protein: expression in human reproductive and nonreproductive tissues. Biol Reprod 1999; 61: 1083-1089. [DOI:10.1095/biolreprod61.4.1083]
3. Handschuh K, Guibourdenche J, Guesnon M, Laurendeau I, Evain-Brion D, Fournier T. Modulation of PAPP-A expression by PPARgamma in human first trimester trophoblast. Placenta 2006; 27 (Suppl.): 127-134. [DOI:10.1016/j.placenta.2005.10.012]
4. Laursen LS, Kjaer-Sorensen K, Andersen MH, Oxvig C. Regulation of insulin-like growth factor (IGF) bioactivity by sequential proteolytic cleavage of IGF binding protein-4 and -5. Mol Endocrinol 2007; 21: 1246-1257. [DOI:10.1210/me.2006-0522]
5. Kniss DA, Shubert PJ, Zimmerman PD, Landon MB, Gabbe SG. Insulinlike growth factors. Their regulation of glucose and amino acid transport in placental trophoblasts isolated from first-trimester chorionic villi. J Reprod Med 1994; 39: 249-256.
6. Nestler JE. Insulin-like growth factor II is a potent inhibitor of the aromatase activity of human placental cytotrophoblasts. Endocrinology 1990; 127: 2064-2070. [DOI:10.1210/endo-127-5-2064]
7. Irwin JC, Suen LF, Martina NA, Mark SP, Giudice LC. Role of the IGF system in trophoblast invasion and pre-eclampsia. Hum Reprod 1999; 14 (Suppl.): 90-96. [DOI:10.1093/humrep/14.suppl_2.90]
8. Dugoff L, Hobbins JC, Malone FD, Porter TF, Luthy D, Comstock CH, et al. First-trimester maternal serum PAPP-A and free-beta subunit human chorionic gonadotropin concentrations and nuchal translucency are associated with obstetric complications: a population-based screening study (the FASTER Trial). Am J Obstet Gynecol 2004; 191: 1446-1451. [DOI:10.1016/j.ajog.2004.06.052]
9. Schiott KM, Christiansen M, Petersen OB, Sorensen TL, Uldbjerg N. The 'Consecutive CombinedTest'- using double test from week 8+0 and nuchal translucency scan, for first trimester screening for Down syndrome. Prenat Diagn 2006; 26: 1105-1109. [DOI:10.1002/pd.1487]
10. Malone FD, Canick JA, Ball RH, Nyberg DA, Comstock CH, Bukowski R, et al. First-trimester or second-trimester screening, or both, for Down's syndrome. N Engl J Med 2005; 353: 2001-2011. [DOI:10.1056/NEJMoa043693]
11. Kagan KO, Wright D, Baker A, Sahota D, Nicolaides KH. Screening for trisomy 21 by maternal age, fetal nuchal translucency thickness, free beta-human chorionic gonadotropin and pregnancy-associated plasma protein-A. Ultrasound Obstet Gynecol 2008; 31: 618-624. [DOI:10.1002/uog.5331]
12. Smith GC, Stenhouse EJ, Crossley JA, Aitken DA, Cameron AD, Connor JM. Early pregnancy levels of pregnancy-associated plasma protein a and the risk of intrauterine growth restriction, premature birth, preeclampsia, and stillbirth. J Clin Endocrinol Metab 2002; 87: 1762-1727. [DOI:10.1210/jcem.87.4.8430]
13. Krantz D, Goetzl L, Simpson JL, Thom E, Zachary J, Hallahan TW, et al. Association of extreme first-trimester free human chorionic gonadotropin-beta, pregnancy-associated plasma protein A, and nuchal translucency with intrauterine growth restriction and other adverse pregnancy outcomes. Am J Obstet Gynecol 2004; 191: 1452-1458. [DOI:10.1016/j.ajog.2004.05.068]
14. Smith GC, Shah I, Crossley JA, Aitken DA, Pell JP, Nelson SM et al. Pregnancy-associated plasma protein A and alpha-fetoprotein and prediction of adverse perinatal outcome. Obstet Gynecol 2006; 107: 161-166. [DOI:10.1097/01.AOG.0000191302.79560.d8]
15. Toal M, Chan C, Fallah S, Alkazaleh F, Chaddha V, Windrim RC, et al. Usefulness of a placental profile in highrisk pregnancies. Am J Obstet Gynecol 2007; 196: e1-e7. [DOI:10.1016/j.ajog.2006.10.897]
16. Toal M, Chaddha V, Windrim R, Kingdom J. Ultrasound detection of placental insufficiency in women with elevated second trimester serum alpha-fetoproteinor human chorionic gonadotropin. J Obstet Gynaecol Can 2008; 30: 198-206. [DOI:10.1016/S1701-2163(16)32756-6]
17. Chafetz I, Kuhnreich I, Sammar M, Tal Y, Gibor Y, Meiri H, et al. First-trimester placental protein 13 screening for preeclampsia and intrauterine growth restriction. Am J Obstet Gynecol 2007; 197: e1-e7. [DOI:10.1016/j.ajog.2007.02.025]
18. Gilpin BJ, Loechel F, Mattei MG, Engvall E, Albrechtsen R, Wewer UM. A novel, secreted form of human ADAM 12 (meltrin alpha) provokes myogenesis in vivo. J Biol Chem 1998; 273: 157-166. [DOI:10.1074/jbc.273.1.157]
19. Lawrence JB, Oxvig C, Overgaard MT, Sottrup-Jensen L, Gleich GJ, Hays LG, et al. The insulin-like growth factor (IGF)-dependent IGF binding protein-4 protease secreted by human fibroblasts is pregnancy-associated plasma protein-A. Proc Natl Acad Sci USA 1999; 96: 3149-3153. [DOI:10.1073/pnas.96.6.3149]
20. Shi Z, Xu W, Loechel F, Wewer UM, Murphy LJ. ADAM 12, a disintegrinmetalloprotease, interacts with insulin-like growth factor-binding protein-3. J Biol Chem 2000; 275: 18574-18580. [DOI:10.1074/jbc.M002172200]
21. Bischof P, DuBerg S, Herrmann W, Sizonenko PC. Pregnancy-associated plasma protein-A (PAPP-A) and HCG in early pregnancy. Br J Obstet Gynaecol 1981; 88: 973-975. [DOI:10.1111/j.1471-0528.1981.tb01683.x]
22. Sinosich MJ, Teisner B, Folkersen J, Saunders DM, Grudzinskas JG. Radioimmunoassay for pregnancy-associated plasma protein A. Clin Chem 1982; 28: 50-53.
23. Wortelboer EJ, Koster MP, Kuc S, Eijkemans MJ, Bilardo CM, Schielen PC, et al. Longitudinal trends in feto-placental biochemical markers, Uterine Artery Doppler flow velocities and maternal blood pressure during the first-trimester of pregnancy. Ultrasound Obstet Gynecol 2011; 38: 383-385. [DOI:10.1002/uog.9029]
24. Sahraravand M, Järvelä IY, Laitinen P, Tekay AH, Ryynänen M. The secretion of PAPP-A, ADAM12, and PP13 correlates with the size of the placenta for the first month ofpregnancy. Placenta 2011; 32: 999-1003. [DOI:10.1016/j.placenta.2011.10.005]
25. Yaron Y, Heifetz S, Ochshorn Y, Lehavi O, Orr-Urtreger A. Decreased first trimester PAPP-A is a predictor of adverse pregnancy outcome. Prenat Diagn 2002; 22: 778-782. [DOI:10.1002/pd.407]
26. Ranta JK, Raatikainen K, Romppanen J, Pulkki K, Heinonen S. Decreased PAPP-A is associated with preeclampsia, premature delivery and small for gestational age infants but not with placental abruption. Eur J Obstet Gynecol Reprod Biol 2011; 157: 48-52. [DOI:10.1016/j.ejogrb.2011.03.004]
27. Roberts JM, Cooper DW. Pathogenesis and genetics of pre-eclampsia. Lancet 2001; 357: 53-56. [DOI:10.1016/S0140-6736(00)03577-7]
28. Khong TY, De Wolf F, Robertson WB, Brosens I. Inadequate maternal vascular response to placentation in pregnancies complicated by pre-eclampsia and by small-for-gestational age infants. Br J Obstet Gynaecol 1986; 93: 1049-1059. [DOI:10.1111/j.1471-0528.1986.tb07830.x]
29. Cowans NJ, Spencer K. First-trimester ADAM12 and PAPP-A as markers for intrauterine fetal growth restriction through their roles in the insulin-like growth factor system. Prenat Diagn 2007; 27: 264-271. [DOI:10.1002/pd.1665]
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