{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T11:02:23Z","timestamp":1771498943347,"version":"3.50.1"},"reference-count":60,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Medicine, Pharmacy, Science and Technology \u201cGE Palade\u201d (UMFST) from Targu-Mures Romania","award":["13610"],"award-info":[{"award-number":["13610"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Pre-eclampsia (PE) is a multisystem disorder that affects 5\u20136% of all pregnancies. Background: PE and intrauterine growth restriction (IUGR) are two major causes of maternal mortality and morbidity. We hypothesize that first-trimester pregnancy-associated plasma protein-A (PAPP-A) levels are useful as a prognostic marker. The aim of our study is to identify the role of PAPP-A and placental thickness in pre-eclampsia screening, as well as its value in IUGR prognosis. Methods: This prospective study was conducted at the Al. Simionescu County Hospital Hunedoara, Romania, Department of Obstetrics and Gynecology, from 12 May to 31 October 2025. A total of 102 patients were included in our study; of these, 28 patients (28.56%) developed pre-eclampsia, and 13 (13.26%) developed IUGR associated with PE. Results: The demographic data showed no differences between groups, except for BMI, smoking habits, and diabetes mellitus. Of the 28 cases of pre-eclampsia, 14.28% had PE detected by 28 weeks, 46.4% had PE associated with IUGR by 33\/34 weeks, and 39.32% had PE detected at term\/delivery. The highest detection rate was at 33\/34 weeks, when the association with IUGR was obvious. For PE with IUGR at 34 weeks, the area under the curve (AUC) was 0.909, with a p-value &lt; 0.001. The PAPP-A cut-off was 0.65 MoM, indicating high sensitivity and specificity for predicting PE. Placental thickness was also assessed, resulting in statistically significant differences between groups. The PAPP-A level shows strong predictive value for PE, especially when associated with placental thickness. Conclusions: This study demonstrates a clear correlation between low PAPP-A in the first trimester of pregnancy, placental thickness in the second trimester, and the subsequent development of pre-eclampsia and its association with IUGR.<\/jats:p>","DOI":"10.3390\/jcm15041607","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T09:55:31Z","timestamp":1771494931000},"page":"1607","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Altered PAPP-A and Placental Thickness in Pre-Eclampsia and Intrauterine Growth Restriction: A Pilot Study"],"prefix":"10.3390","volume":"15","author":[{"given":"Liviu","family":"Moraru","sequence":"first","affiliation":[{"name":"Department of Anatomy, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, 540142 Targu Mures, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raluca","family":"Moraru","sequence":"additional","affiliation":[{"name":"Department of Anatomy, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, 540142 Targu Mures, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1596-6353","authenticated-orcid":false,"given":"Melinda Ildiko","family":"Mitranovici","sequence":"additional","affiliation":[{"name":"Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3228-7881","authenticated-orcid":false,"given":"Romeo","family":"Micu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Medicine and Pharmacy Iuliu Hatieganu, 400347 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1002\/uog.20105","article-title":"ISUOG Practice Guidelines: Role of ultrasound in screening for and follow-up of pre-eclampsia","volume":"53","author":"Sotiriadis","year":"2019","journal-title":"Ultrasound Obs. 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