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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, Joachim W.

Editorial Board Member: / Bancalari, Eduardo / Greenough, Anne / Genc, Mehmet R. / Chervenak, Frank A. / Chappelle, Joseph / Bergmann, Renate L. / Bernardes, J.F. / Bevilacqua, G. / Blickstein, Isaac / Cabero Roura, Luis / Carbonell-Estrany, Xavier / Carrera, Jose M. / D`Addario, Vincenzo / D'Alton, MD, Mary E. / Dimitrou, G. / Grunebaum, Amos / Hentschel, Roland / Köpcke, W. / Kawabata, Ichiro / Keirse, Marc J.N.C. / Kurjak M.D., Asim / Lee, Ben H. / Levene, Malcolm / Lockwood, Charles J. / Marsal, Karel / Makatsariya, Alexander / Nishida, Hiroshi / Ogata, Edward / Papp, Zoltán / Pejaver, Ranjan Kumar / Pooh, Ritsuko K. / Romero, Roberto / Saugstad, Ola D. / Schenker, Joseph G. / Sen, Cihat / Seri, Istvan / Vetter, Klaus / Winn, Hung N. / Young, Bruce K. / Zimmermann, Roland

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The efficacy of first-trimester PAPP-A and free βhCG levels for predicting adverse pregnancy outcome

Zehra Nese Kavak1 / Alin Basgul2 / Koray Elter3 / Meltem Uygur4 / Husnu Gokaslan5






Corresponding author: Dr. Koray Elter, MD Kuyubasi Sk. Fenik Apt. No: 20/17 Feneryolu Kadikoy 34724 Istanbul/Turkey

Citation Information: Journal of Perinatal Medicine. Volume 34, Issue 2, Pages 145–148, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/JPM.2006.026, March 2006

Publication History

June 16, 2005
September 28, 2005
October 2, 2005
Published Online:


Objective: To determine whether first-trimester measurements of maternal serum PAPP-A and free βhCG levels were associated with adverse pregnancy outcomes.

Study Design: First trimester maternal serum free βhCG and PAPP-A were measured in 490 singleton pregnancies. Pregnancies were followed by the fetal-maternal unit, and predictive efficacy of these markers for small for gestational age (SGA) babies, gestational diabetes mellitus and hypertensive disorders were analyzed by cut-off values determined by using a ROC analysis, and also, by using the fifth percentile as the cut-off value.

Results: The sensitivities for PAPP-A in predicting pregnancies with a SGA baby and those complicated by a hypertensive disorder were 49% and 73%, respectively, when optimal cut-off values were used. Specificities were 76% and 65%, respectively. Serum free βhCG had no predictive value for individual pregnancy outcomes.

Conclusion: Efficacy of first trimester maternal serum markers in predicting adverse pregnancy outcome is low. Even after optimization of cut-off values, these markers do not appear to be clinically acceptable as an effective tool for screening for adverse pregnancy outcomes.

Keywords: Diabetes; hCG; PAPP-A; preeclampsia; pregnancy outcome; screening; SGA

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