Predictive values of maternal serum PAPP-A level, uterine artery Doppler velocimetry, and fetal biometric measurements for poor pregnancy and poor neonatal outcomes in pregnant women

Abstract

Objective: To determine predictive values of maternal serum PAPP-A (msPAPP-A) levels, uterine artery Doppler velocimetry, and fetal biometric measurements (FBMs) for poor pregnancy and poor neonatal outcomes.

Material and Methods: This prospective cohort study was conducted on singleton pregnancies followed until delivery. Pregnancy and neonatal outcomes were evaluated with respect to the msPAPP-A level at the 11th-14th weeks, uterine artery Doppler velocimetry at the 15th-18th weeks, and FBMs at the 20th-24th and 28th-32nd weeks of pregnancy.

Results: One hundred fifty-eight women constituted the study group; 17 (10.75%) of them had at least one poor pregnancy outcome. The cut-off point of 0.72 multiple of the median (MoM) for the PAPP-A level achieved a sensitivity of 82.4% and a specificity of 29.8% for poor pregnancy outcomes. The mean birth weight was significantly lower in the subgroup with a higher mean pulsatility index of uterine arteries (UAPImean >= 1.19) (p=0.025) as well as in the subgroup with a higher mean resistance index of uterine arteries (UARImean >= 0.62) (p=0.013). When the subgroup of pregnant women under the risk of early-onset IUGR according to FBMs was compared to the low-risk group, statistically significant differences were seen in terms of pregnancy outcomes (p=0.045) and birth weight (p=0.011).

Conclusion: Maternal serum PAPP-A level and FBMs could be used for predicting pregnancy outcomes, while uterine artery Doppler velocimetry and FBMs could be used for predicting neonatal outcomes, specifically the birth weight.