THE INFLUENCE OF PREGNANCY-ASSOCIATED PLASMA PROTEIN А (РАРР-А) ON INTRAUTERINE GROWTH RESTRICTION
Introduction: the search of methods enabling to predict fetal growth impairment is an important issue for modern obstetrics. Pregnancy-associated plasma protein А (РАРР-А) is considered to be one of the predictors of fetal chromosomal mutations. The associations between reduced РАРР-А levels in first pregnancy trimester and the development of intrauterine growth restriction (IUGR) is being extensively studied over the last years. The current normal range of РАРР-А in Kazakhstan is considered to be 0,5-2,05.
Aim: to study the associations between РАРР-А levels in first pregnancy trimester and the development of IUGR.
Methods: this was the case-control study. The study group comprised 72 cases with IGR. The control group comprised 288 cases without IUGR. To study outcomes, the РАРР-А levels were dichotomized as below 0,5 and within 0,5-2,05 range. The data analysis included descriptive statistics, comparison of nominal data with Pearson’s chi-square and odds ratio.
Results: the pregnancy associated with IGR was combined with hypertension in 43% of cases, placental impairment in 25% of cases, and was 3,5 times more likely to threaten the fetus state. The perinatal mortality in study group was equal to 11.1%, and in the control group it composed 0,3%.
The odds ratio to have IGR was 5,46 (95% CI 2.80; 10.68) for women with РАРР-А level below 0,5, which means that for this category of pregnant women the chance to develop intrauterine growth retardation was 5,46 times higher than for women with normal PAPP-A range.
Discussion: the associations between РАРР-А levels and IGR are being extensively studied over the last years. Currently around 90% of pregnant women have this test in first pregnancy trimester, which means that its implementation to predict the development of IGR will cause no additional costs.
Conclusions: РАРР-А levels may be used as the predictors of IGR, along with other methods.
Anar S. Kystaubayeva 1, http://orcid.org/0000-0002-8712-3307
Gulyash А. Tanysheva 1, http://orcid.org/0000-0002-9074-6302
Meryert G. Sharypova 1,
Saltanat. S. Kyrykbaeva 2, http://orcid.org/0000-0001-6151-6025
Yuliya M. Semenova 3, http://orcid.org/0000-0003-1324-7806
Ion Bologan 4
Semey State Medical University,
1 Department of internship in obstetrics and gynecology;
2 Department of Public Health;
3 Department of surgical diseases;
Semey, Kazakhstan;
4 State University of Medicine and Pharmacy named after N. Testemitanu, Department of obstetrics and gynecology Nr 1, Chisinau, Moldova.
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Kystaubayeva A.S., Tanysheva G.А., Sharypova M.G., Kyrykbaeva S.S., Semenova Yu.M., Ion Bologan The influence of pregnancy-associated plasma protein А (РАРР-А) on intrauterine growth restriction. Nauka i Zdravookhranenie [Science & Healthcare]. 2017, 5, pp. 55-66.