{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T14:07:39Z","timestamp":1773324459130,"version":"3.50.1"},"reference-count":15,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2003,11,20]],"date-time":"2003-11-20T00:00:00Z","timestamp":1069286400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2003,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Aims:\u2002<\/jats:bold> To investigate whether low pregnancy associated plasma protein\u2010A (PAPP\u2010A) levels in the first trimester of pregnancy are associated with subsequent intrauterine fetal growth restriction, stillbirth and preterm delivery.<\/jats:p><jats:p><jats:bold>Methods:\u2002<\/jats:bold> A retrospective review of pregnancy outcomes was undertaken in women who had PAPP\u2010A carried out in the first trimester of pregnancy at the time of nuchal translucency scan. Pregnancy outcomes were assessed by the review of medical records, and postal questionnaires. Delivery details were collected, including livebirth, neonatal birthweight and gestational age at delivery. The \u03c7<jats:sup>2<\/jats:sup> test was used to investigate the association between low first trimester serum PAPP\u2010A levels and adverse fetal outcomes. Unpaired <jats:italic>t<\/jats:italic>\u2010test was used for continuous variables. Sensitivities and specificities were then calculated.<\/jats:p><jats:p><jats:bold>Results:\u2002<\/jats:bold> A total of 894 women who had blood collected for PAPP\u2010A were identified, and data was obtained for 827 deliveries. Each had a normal karyotype. There were six intrauterine deaths, 13 babies with birthweights below the 3rd centile, 55 babies weighing below the 10th centile, and 96 women who delivered prematurely. Four of six intrauterine deaths had low PAPP\u2010A levels (&lt;0.5\u00a0multiples of the median), with a relative risk of 13.75. Low PAPP\u2010A levels were associated with fetal weight below the 10th centile (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.01) but not the 3rd centile. There was no statistically significant association between low maternal serum PAPP\u2010A levels and preterm delivery.<\/jats:p><jats:p><jats:bold>Conclusion:\u2002<\/jats:bold> At 11\u201313\u00a0weeks\u2019 gestation, low maternal serum PAPP\u2010A levels are associated with fetal death <jats:italic>in utero<\/jats:italic> and birthweight below the 10th centile. First trimester PAPP\u2010A may be a useful tool for identifying pregnancies at risk of adverse fetal outcomes.<\/jats:p>","DOI":"10.1046\/j.0004-8666.2003.00126.x","type":"journal-article","created":{"date-parts":[[2003,11,21]],"date-time":"2003-11-21T04:22:31Z","timestamp":1069388551000},"page":"438-442","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Association between first trimester maternal serum pregnancy associated plasma protein\u2010A and adverse pregnancy outcome"],"prefix":"10.1111","volume":"43","author":[{"given":"Michele","family":"Kwik","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Morris","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2003,11,20]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.humrep.a137965"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02114602"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0014-5793(01)02760-0"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.96.6.3149"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.3109\/00016349509024379"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1993.tb12973.x"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2000.tb11618.x"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1754.1996.tb00965.x"},{"key":"e_1_2_7_10_2","unstructured":"Georgetown University [Internet].Washington WA:Georgetown University USA;[updated 2003; cited 2003]. Available from:http:\/\/epsilon3.georgetown.edu\/~cball\/cgi\u2010bin\/webchi\/web_chi.cgi."},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0223(199908)19:8<788::AID-PD609>3.0.CO;2-Q"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(83)90341-1"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.3109\/00016349009028701"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.87.4.8430"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0223(199802)18:2<147::AID-PD231>3.0.CO;2-W"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0303-7207(98)00041-0"}],"container-title":["Australian and New Zealand Journal of Obstetrics and Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1046%2Fj.0004-8666.2003.00126.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1046\/j.0004-8666.2003.00126.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T06:38:36Z","timestamp":1697179116000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1046\/j.0004-8666.2003.00126.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,11,20]]},"references-count":15,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2003,12]]}},"alternative-id":["10.1046\/j.0004-8666.2003.00126.x"],"URL":"https:\/\/doi.org\/10.1046\/j.0004-8666.2003.00126.x","archive":["Portico"],"relation":{},"ISSN":["0004-8666","1479-828X"],"issn-type":[{"value":"0004-8666","type":"print"},{"value":"1479-828X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003,11,20]]},"assertion":[{"value":"2003-11-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}