{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T03:00:43Z","timestamp":1791342043126,"version":"4.3.1"},"reference-count":29,"publisher":"Walter de Gruyter GmbH","issue":"4","funder":[{"DOI":"10.13039\/100008723","name":"Suomen L\u00e4\u00e4ketieteen S\u00e4\u00e4ti\u00f6","doi-asserted-by":"crossref","award":["4487"],"award-info":[{"award-number":["4487"]}],"id":[{"id":"10.13039\/100008723","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpm-2022-0241_abs_001\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To evaluate different cut-off values of first trimester pregnancy associated plasma protein-A (PAPP-A) in screening for adverse pregnancy outcomes in a retrospective cohort study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2022-0241_abs_002\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>During the study period of 1.1.2014\u201331.12.2018, total of 23,482 women with singleton pregnancies participated in first trimester combined screening for chromosomal abnormalities. Maternal serum PAPP-A multiple of medians (MoM) levels were measured, and study population was divided into three study groups of PAPP-A\u00a0\u22640.40 (n=1,030),\u00a0\u22640.35 (n=630) and\u00a0\u22640.30 (n=363) MoM.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2022-0241_abs_003\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Small for gestational age (SGA), preterm birth (PTB) and composite outcome (SGA, hypertensive disorder of pregnancy (HDP) and\/or PTB) were more frequent in all three PAPP-A MoM study groups and pre-eclampsia in\u00a0\u22640.40 and\u00a0\u22640.35 study groups than in their control groups (p\u00a0&lt;\u00a00.05). The odds ratio (OR) for SGA varied from 3.7 to 5.4 and sensitivity and specificity from 6.9 to 13.8% and from 95.9 to 98.6%, between study groups. Using PAPP-A\u00a0\u22640.30 MoM as a screening cut-off instead of PAPP-A\u00a0\u22640.40 MoM, resulted in approximately 50% reduction in screening detection of SGA and PTB.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2022-0241_abs_004\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>PAPP-A\u00a0\u22640.40 MoM should be considered as\u00a0a primary screening cut-off for adverse pregnancy outcomes as approximately 23% will develop either SGA, HDP or PTB. It seems to be the best cut-off to screen for SGA.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpm-2022-0241","type":"journal-article","created":{"date-parts":[[2022,9,22]],"date-time":"2022-09-22T05:20:30Z","timestamp":1663824030000},"page":"500-509","source":"Crossref","is-referenced-by-count":13,"title":["First trimester low maternal serum pregnancy associated plasma protein-A (PAPP-A) as a screening method for adverse pregnancy outcomes"],"prefix":"10.1515","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2034-5511","authenticated-orcid":false,"given":"Tiina","family":"Kantomaa","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Centre , Oulu University Hospital , Oulu , Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8234-4434","authenticated-orcid":false,"given":"Marja","family":"V\u00e4\u00e4r\u00e4sm\u00e4ki","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Centre , Oulu University Hospital , Oulu , Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mika","family":"Gissler","sequence":"additional","affiliation":[{"name":"Finnish Institute for Health and Welfare , Helsinki , Finland"},{"name":"Academic Primary Health Care Centre, Region Stockholm , Stockholm , Sweden"},{"name":"Department of Molecular Medicine and Surgery , Karolinska Institute , Stockholm , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikko","family":"Sairanen","sequence":"additional","affiliation":[{"name":"PerkinElmer , Turku , Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9720-9676","authenticated-orcid":false,"given":"Jaana","family":"Nevalainen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Centre , Oulu University Hospital , Oulu , Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2022,9,23]]},"reference":[{"key":"2023050402001736827_j_jpm-2022-0241_ref_001","doi-asserted-by":"crossref","unstructured":"Lawrence, JB, Oxvig, C, Overgaard, MR, Sottrup-Jensen, L, Gleich, GJ, Hays, LG, et al.. 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