Turkish Journal of Medical Sciences




To determine whether or not there is a relationship between first-trimester maternal serum pregnancy-associated placental protein (PAPP-A) levels and fetal macrosomia in nondiabetic mothers. Materials and methods: In this study, 63 consecutive term macrosomic neonates (Group 1) (birth weight >= 4000 g) and 100 consecutive appropriate-for-gestational-age (AGA) term neonates (Group 2) were included. Transabdominal ultrasound examinations were performed to diagnose any major fetal defects and to measure crown-rump length (CRL) and fetal nuchal translucency (NT) thickness. Blood samples were drawn from each woman in order to obtain fasting blood glucose, PAPP-A, and free beta-human chorionic gonadotropin (beta-hCG) levels. Ultrasound measurements of the fetal biparietal diameter, abdominal circumference, and femur length were obtained at 29-34 weeks of gestation. Results: The two groups were similar with respect to maternal age, parity, and gestational age in the first trimester. There were no significant differences between the groups in terms of the mean plasma levels of PAPP-A, free beta-HCG (as MoM values), mean CRL, and NT measurements. First-trimester PAPP-A levels were not correlated with birth weight (r = -0.116, P = 0.146), maternal age (r = 0.137, P = 0.089), maternal body mass index (BMI) in the first trimester (r = -0.037, P = 0.641) or at delivery (r = 0.042, P = 0.620), fasting blood glucose in the first trimester (r = -0.019, P = 0.816), macrosomia (r = -0.092, P = 0.249), or the occurrence of male sex (r = -0.074, P = 0.358) by the Pearson and Spearman correlations. In addition, first-trimester PAPP-A levels were not correlated with ultrasonographic measurements at 29-34 weeks of gestation. Conclusion: Although PAPP-A may promote fetal growth and development through metabolic and differentiation pathways, it seems that there is no relationship between PAPP-A levels and macrosomia.


PAPP-A, macrosomia, first-trimester screening

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