First trimester serum PAPP-A is associated with placenta accreta: a retrospective study

Abstract

Purpose

Our objective of this study was to investigate whether first trimester serum pregnancy-associated plasma protein-A (PAPP-A) differed amongst pregnancies with placenta previa-accreta and non-adherent placenta previa and healthy pregnancies by a retrospective cohort analysis.

Methods

A total of 177 pregnant females were included in the study, as follows: 35 cases of placenta previa-accreta, 30 cases of non-adherent placenta previa, and 112 cases of BMI and age matched, healthy pregnant controls. PAPP-A multiples of the median (MoM) were acquired from laboratory data files in 1 January 2017–30 September 2019. The probable maternal serum biochemical predictor of placenta accreta was analyzed by using multiple logistic regression analysis.

Results

PAPP-A MoM of placenta previa-accreta group was significantly higher than those of the non-adherent placenta previa group and control group (p = 0.009 < 0.05, p < 0.001). Serum PAPP-A was found to be significantly positively associated with placenta accreta after adjusted gestational week at time of blood sampling, BMI, age, smoking, and previous cesarean section history (OR: 3.51; 95% CI: 1.77–6.94; p = 0.0003 < 0.05). In addition, smoking (OR: 9.17; 95% CI: 1.69–49.62; p = 0.010 < 0.05) and previous cesarean section history (OR: 2.75; 95% CI: 1.23–6.17; p = 0.014 < 0.05) were also significantly associated with placenta accreta.

Conclusion

Increased first trimester serum PAPP-A was significantly positively associated with placenta accreta, suggesting that the potential role of PAPP-A in identifying pregnancies at high risk for placenta accreta. Smoking and previous cesarean section history may be the risk factors for accreta in placenta previa patients.

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Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

PAPP-A:

Pregnancy-associated plasma protein-A

BMI:

Body mass index

MoM:

Multiples of the median

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Funding

This study was supported by the Research Fund for Academician Lin He New Medicine, China (No. JYHL2018FMS15).

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Authors

Contributions

FGW and DMM conceived and designed the study. FGW and LXZ participated in the design. FGW drafted the manuscript. FGW, YPW, and JSW performed the statistical analysis. SXC participated in the chart making and collecting information in revised the manuscript. FR and HS participated in the design of the study and revised the manuscript. All authors have read and approved the final manuscript.

Corresponding authors

Correspondence to Liangxi Zhu or Dongmei Man.

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The authors declare that they have no competing interests.

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The study was approved by the Human Ethics Committee of the Affiliated Hospital of Jining Medical University (Shandong, China) (2019-zr-016).

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Wang, F., Chen, S., Wang, J. et al. First trimester serum PAPP-A is associated with placenta accreta: a retrospective study. Arch Gynecol Obstet (2021). https://doi.org/10.1007/s00404-020-05960-1

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Keywords

  • PAPP-A
  • First trimester serum
  • Placenta accreta
  • Association