{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T03:00:20Z","timestamp":1791342020396,"version":"4.3.1"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,11,3]],"date-time":"2016-11-03T00:00:00Z","timestamp":1478131200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the association between pregnancy\u2010associated placental protein A (PAPP\u2010A) levels in the first trimester of pregnancy and adverse pregnancy outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A retrospective study included data from a group of patients in the first trimester of pregnancy with PAPP\u2010A levels below 0.3 multiples of median who attended the Helsinki University Hospital, Finland, between January 1, 2009 and December 31, 2012; an age\u2010matched control group of patients with PAPP\u2010A levels 0.9\u20131.1 multiples of median was also enrolled. The incidences of adverse pregnancy outcomes in the two groups were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 961 patients included in each of the groups. Significantly increased risks of aneuploidies (odds ratio [OR] 116.0; 95% confidence interval [CI] 16.2\u2013836.6) and spontaneous abortion (OR 7.7; 95% CI 2.7\u201322.0) were observed among patients with low PAPP\u2010A (both <jats:italic>P<\/jats:italic>&lt;0.001). Preterm delivery (OR 2.5, 95% CI 1.8\u20133.5), pre\u2010eclampsia (OR 10.9, 95% CI 4.3\u201327.6), and small for gestational age neonates (OR 4.9, 95% CI 3.2\u20137.5) were also observed more frequently among patients with low PAPP\u2010A (all <jats:italic>P<\/jats:italic>&lt;0.001). There were 9 (0.9%) stillbirths recorded among patients with low PAPP\u2010A and none recorded in the control group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Low PAPP\u2010A was associated with adverse pregnancy outcomes and aneuploidy. These risks should be considered when planning follow\u2010up for patients with low PAPP\u2010A pregnancies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.12002","type":"journal-article","created":{"date-parts":[[2017,7,21]],"date-time":"2017-07-21T05:56:09Z","timestamp":1500616569000},"page":"76-82","source":"Crossref","is-referenced-by-count":24,"title":["Low maternal pregnancy\u2010associated plasma protein A during the first trimester of pregnancy and pregnancy outcomes"],"prefix":"10.1002","volume":"136","author":[{"given":"Marja","family":"Kaijomaa","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Helsinki Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leena","family":"Rahkonen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Helsinki Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veli\u2010Matti","family":"Ulander","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Helsinki Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esa","family":"H\u00e4m\u00e4l\u00e4inen","sequence":"additional","affiliation":[{"name":"HUSLAB and Department of Clinical Chemistry University of Helsinki Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Alfthan","sequence":"additional","affiliation":[{"name":"HUSLAB and Department of Clinical Chemistry University of Helsinki Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helene","family":"Markkanen","sequence":"additional","affiliation":[{"name":"HUSLAB and Department of Clinical Chemistry University of Helsinki Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seppo","family":"Heinonen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Helsinki Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vedran","family":"Stefanovic","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Helsinki Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,11,3]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tem.2012.02.008"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ghir.2006.11.003"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ymgme.2005.07.028"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4407"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4406"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4141"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.407"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2011.03.004"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1890"},{"key":"e_1_2_7_11_1","first-page":"145","article-title":"Maternal level of pregnancy\u2010associated plasma protein A as a predictor of pregnancy failure in threatened abortion","volume":"34","author":"Hanita O","year":"2012","journal-title":"Malays J Pathol"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1898"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.2578"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016349.2010.493195"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.2298\/VSP110530023L"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13224-013-0481-4"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2008.00912.x"},{"key":"e_1_2_7_18_1","unstructured":"Eduskunta the Parliament of Finland.Health Care Act 339\/2011. 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