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Low sensitivity, positive predictive value: low PAPP-A tied to poor pregnancy outcomes.(Obstetrics)

OB GYN News

| April 01, 2004 | Sullivan, Michele G. | COPYRIGHT 2004 International Medical News Group. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan.  All inquiries regarding rights should be directed to the Gale Group. (Hide copyright information)Copyright

NEW ORLEANS -- A low first-trimester serum level of pregnancy-associated plasma protein A is an independent risk factor for several adverse obstetric outcomes, Dr. Lorraine Dugoff reported at the annual meeting of the Society for Maternal-Fetal Medicine.

Although many of the associations are highly statistically significant, the sensitivity and positive predictive values for the individual outcomes are relatively low, said Dr. Dugoff, a coinvestigator for the First and Second Trimester Evaluation of Risk for Aneuploidy (FASTER) trial.

The FASTER trial is a National Institutes of Health-sponsored study conducted at 15 major medical centers across the United States to compare first- and second-trimester aneuploidy screening. More than 38,000 women were screened using nuchal translucency measurement and serum markers in the first trimester, and using quad screening in the second trimester.

Dr. Dugoff's subanalysis of the FASTER trial examined the relationship between poor outcomes, high and low serum levels of pregnancy-associated plasma protein A (PAPP-A), and high and low serum levels of free [beta]-HCG in the first trimester. Patients with known fetal anomalies were excluded from this analysis, said Dr. Dugoff of the University of Colorado, Denver.

The strongest association occurred between ...

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