Maternal PAPP-A Levels at 11 - 13 Weeks of Gestation Predict Foetal and Neonatal Growth

Recent reports suggest that maternal serum levels of pregnancy-associated plasma protein A (PAPP-A) may predict perinatal outcome. PAPP-A is a syncytiotrophoblast derived protease for insulin-like growth factor binding protein (IGFBP4); its protease activity cleaves complexed growth factor binding protein increasing insulin-like growth factor I (IGF-I) bioavailability. The aim of our study was to evaluate the correlation between maternal PAPP-A serum levels and neonatal growth. We analysed 100 full term and preterm (30 36 weeks) small for gestational age (SGA) and adequate for gestational age (AGA) babies whose mothers had been tested for serum PAPP-A at 11 13 weeks of gestation. We found a significant positive correlation between maternal PAPP-A and neonatal weight, length, and head circumference at birth in both term and preterm infants. Low maternal PAPP-A serum levels (maternal PAPP-A < 0.5) were associated with small for gestational age neonates. A significant positive correlation was also evident between maternal PAPP-A and babies’ growth parameters at 6 months of age. Our results suggest that maternal levels of PAPP-A in early pregnancy affect growth during both foetal and early postnatal life.