Levels of pregnancy-associated plasma protein-A: A predictor of fetal macrosomia in non-diabetic women

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 fetalmacrosomia, 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. A2.6-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. (C) 2013 Elsevier Espana, S.L. All rights reserved.