Science & Healthcare

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.