First trimester maternal serum PAPP-A, beta-hCG and ADAM12 in prediction of small-for-gestational-age fetuses

TY - JOUR

T1 - First trimester maternal serum PAPP-A, beta-hCG and ADAM12 in prediction of small-for-gestational-age fetuses

AU - Pihl, Kasper

AU - Larsen, Torben

AU - Krebs, Lone

AU - Christiansen, Michael

N1 - Copyright (c) 2008 John Wiley & Sons, Ltd.

PY - 2008/12

Y1 - 2008/12

N2 - OBJECTIVE: To examine the ability of predicting fetuses being small-for-gestational-age (SGA) at delivery with the maternal serum markers pregnancy-associated plasma protein A (PAPP-A), beta-human chorionic gonadotrophin (beta-hCG) and A disintegrin and metalloprotease 12 (ADAM12) in first trimester.METHODS: In all,36 cases being SGA (birth weight < 5th centile) and 108 controls being non-SGA were matched on ethnicity (only Caucasians), smoking status (only nonsmokers), body mass index (BMI), age and parity. Stored blood samples from PAPP-A and beta-hCG testing obtained at gestational age (GA) of 8 weeks to 13 weeks and 6 days were analyzed for ADAM12. Median MoM values were compared using Mann-Whitney test. Monte Carlo estimation and receiver-operator-characteristics curves were used to asses screening performance.RESULTS: Median MoM values of PAPP-A (0.64 vs 1.02, p < 0.001), beta-hCG (0.74 vs 1.04, p = 0.007) and ADAM12 (0.74 vs 0.97, p = 0.004) were significantly reduced in cases compared to controls. The combination of PAPP-A MoM and beta-hCG MoM yielded a detection rate (DR) for SGA of 26% for a 5% false-positive rate (FPR). Addition of ADAM12 only improved (28% DR for a 5% FPR) screening performance modestly.CONCLUSION: Early prediction of fetuses being SGA is feasible with the combination of first trimester PAPP-A, beta-hCG and ADAM12. Screening performance is approaching clinical relevance. The inclusion of further markers is an attractive option.

AB - OBJECTIVE: To examine the ability of predicting fetuses being small-for-gestational-age (SGA) at delivery with the maternal serum markers pregnancy-associated plasma protein A (PAPP-A), beta-human chorionic gonadotrophin (beta-hCG) and A disintegrin and metalloprotease 12 (ADAM12) in first trimester.METHODS: In all,36 cases being SGA (birth weight < 5th centile) and 108 controls being non-SGA were matched on ethnicity (only Caucasians), smoking status (only nonsmokers), body mass index (BMI), age and parity. Stored blood samples from PAPP-A and beta-hCG testing obtained at gestational age (GA) of 8 weeks to 13 weeks and 6 days were analyzed for ADAM12. Median MoM values were compared using Mann-Whitney test. Monte Carlo estimation and receiver-operator-characteristics curves were used to asses screening performance.RESULTS: Median MoM values of PAPP-A (0.64 vs 1.02, p < 0.001), beta-hCG (0.74 vs 1.04, p = 0.007) and ADAM12 (0.74 vs 0.97, p = 0.004) were significantly reduced in cases compared to controls. The combination of PAPP-A MoM and beta-hCG MoM yielded a detection rate (DR) for SGA of 26% for a 5% false-positive rate (FPR). Addition of ADAM12 only improved (28% DR for a 5% FPR) screening performance modestly.CONCLUSION: Early prediction of fetuses being SGA is feasible with the combination of first trimester PAPP-A, beta-hCG and ADAM12. Screening performance is approaching clinical relevance. The inclusion of further markers is an attractive option.

KW - ADAM Proteins

KW - ADAM12 Protein

KW - Adolescent

KW - Adult

KW - Case-Control Studies

KW - Chorionic Gonadotropin, beta Subunit, Human

KW - Cohort Studies

KW - Feasibility Studies

KW - Female

KW - Fetal Growth Retardation

KW - Humans

KW - Infant, Newborn

KW - Infant, Small for Gestational Age

KW - Membrane Proteins

KW - Mothers

KW - Pregnancy

KW - Pregnancy Trimester, First

KW - Pregnancy-Associated Plasma Protein-A

KW - Prenatal Diagnosis

KW - Young Adult

KW - Evaluation Studies

KW - Journal Article

U2 - 10.1002/pd.2141

DO - 10.1002/pd.2141

M3 - Journal article

C2 - 19003798

SN - 0197-3851

VL - 28

SP - 1131

EP - 1135

JO - Prenatal Diagnosis

JF - Prenatal Diagnosis

IS - 12

ER -