EP37.30: Low level of PAPP‐A MoM and obstetric outcomes in SGA and AGA babies: a retrospective cohort study

Le résumé fourni par la source

to compare obstetric and neonatal outcomes according to PAPP-A MoM at combined test. retrospective cohort study of all combined test performed in singletons between 2015 and 2021 with available pregnancy outcome. Pregnancy ending < 23 weeks were excluded. The following variables were recorded: maternal age and BMI, conception mode, free-betahCG and PAPP-A values and their MoM, CRL, NT and the risk for T21, T13 and T18, Gestational Age (GA) at delivery, birthweight and centile, Apgar at 5 min, arterial pH (pHa) and base excess (BE), need for NICU, blood loss at birth. We defined adverse neonatal outcome if any among Apgar < 7 at 5', pHa < 7.10, BE < −10, NICU admission occurred. Neonates were defined Small (SGA)/Adequate (AGA) for GA if birthweight was above/below10 cle. We compared obstetric outcomes between women with PAPP-A MoM above/below 0.42 MoM (5th cle). 1826 combined test with pregnancy outcome were available; among these, 76 (4.2%) women had PAPP-A MoM < 5th cle, which did not differ according to conception type, maternal age or BMI (p > 0.05). Table 1 shows outcomes according to PAPP-A MoM. We then excluded all SGA (n = 201, 11%) and found that having a low PAPP-A increased the risk of adverse composite neonatal outcome (OR 2.1, CI95% 1.1-4.1, p = .028) and remained associated with lower free-betahCG MoM (p = .004), lower blood loss at delivery (p = .015) and lower birthweight (p = 0.033). this study showed an increased risk of adverse composite neonatal outcome in AGA babies with PAPP-A MoM < 5th cle, warranting further investigations.

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