{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T13:33:20Z","timestamp":1782567200430,"version":"3.54.5"},"reference-count":32,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2005,8,8]],"date-time":"2005-08-08T00:00:00Z","timestamp":1123459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Prenatal Diagnosis"],"published-print":{"date-parts":[[2005,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Previous studies have shown an association between low first trimester maternal serum free \u03b2\u2010hCG and PAPP\u2010A and subsequent development of pregnancy complications. Similarly, uterine artery Doppler in the late second trimester has shown that high impedance to flow is associated with increased risk for preeclampsia and fetal growth restriction. The objective of this study is to determine whether there is an association between the maternal serum concentration of PAPP\u2010A and free \u03b2\u2010hCG at 11\u201313<jats:sup>+6<\/jats:sup> weeks with the uterine artery pulsatility index (PI) at 22\u201324 weeks, and secondly, to compare the screening characteristics of the two methods in the prediction of adverse pregnancy outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Maternal serum PAPP\u2010A and free \u03b2\u2010hCG at 11\u201313<jats:sup>+6<\/jats:sup> weeks and uterine artery PI at 22\u201324 weeks were measured in 4390 women with singleton pregnancies. Pregnancies with chromosomal defects or fetal anomalies were excluded. The biochemical and Doppler measurements were compared between those with normal outcome and those resulting in spontaneous preterm delivery, pre\u2010eclampsia and fetal growth restriction (FGR). Detection rates using a combination of the biochemical and Doppler measurements were investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the pregnancies resulting in pre\u2010eclampsia (<jats:italic>n<\/jats:italic> = 64) and FGR (<jats:italic>n<\/jats:italic> = 172), the median PAPP\u2010A was lower (0.844 and 0.813 MoM), the median uterine artery mean PI was higher (1.56 and 1.18) but the median free \u03b2hCG was not significantly different (0.923 and 0.933 MoM) than in the normal outcome group. In the preterm delivery group (<jats:italic>n<\/jats:italic> = 159), the median free \u03b2\u2010hCG (0.944 MoM) and uterine artery mean PI (1.06) were not significantly different from normal but the median PAPP\u2010A (0.928 MoM) was significantly lower than normal. In screening for pre\u2010eclampsia, the detection rate, for a 5% false\u2010positive rate, was 14.1% for PAPP\u2010A, 54.7% for uterine artery mean PI and 62.1% for a combination of PAPP\u2010A and uterine artery mean PI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Maternal serum PAPP\u2010A at 11\u201313<jats:sup>+6<\/jats:sup> of gestation is significantly lower in adverse pregnancy outcomes. The combination of first trimester serum PAPP\u2010A and uterine artery mean PI at 22\u201024 weeks improves the screening efficacy for the prediction of pre\u2010eclampsia. Copyright \u00a9 2005 John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pd.1251","type":"journal-article","created":{"date-parts":[[2005,8,8]],"date-time":"2005-08-08T11:46:26Z","timestamp":1123501586000},"page":"949-953","source":"Crossref","is-referenced-by-count":174,"title":["Prediction of pregnancy complications by first\u2010trimester maternal serum PAPP\u2010A and free \u03b2\u2010hCG and with second\u2010trimester uterine artery Doppler"],"prefix":"10.1002","volume":"25","author":[{"given":"Kevin","family":"Spencer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina K. 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