Niveles de proteína placentaria A asociada a la gestación: Predictor de macrosomía fetal en gestantes no diabéticas

Objectives

To determine whether plasma levels of pregnancy-associated plasma protein-A (PAPP-A) expressed in multiples of the median (MoM) can be used to predict fetal macrosomia, independently of other clinical or ultrasound parameters, and to determine the risk of having a macrosomic fetus in pregnant women, based on PAPP-A values.

Material and methods

An epidemiological, observational, analytical, case-control study was performed between June 2011 and July 2012 in patients at the the University Hospital of Ourense.

Results

The results of this study suggest that maternal levels of PAPP-A (MoM) are positively associated with fetal weight. A 2.6-fold increment in the risk of having a macrosomic neonate was found for each point-increase in PAPP-A.

Conclusions

PAPP-A values expressed in MoM are an independent predictor of fetal macrosomy and are not influenced by maternal factors or early fetal ultrasound parameters. PAPP-A (MoM) values exceeding 1.89 can predict fetal macrosomia with a specificity of above 80%. In 75% of cases, PAPP-A (MoM) values discriminate between future neonates with normal weight and those with macrosomia.