{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T09:33:26Z","timestamp":1768901606264,"version":"3.49.0"},"reference-count":22,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2020,7,3]],"date-time":"2020-07-03T00:00:00Z","timestamp":1593734400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>In twin gestation, the relationship between pregnancy associated plasma protein (PAPP-A) and perinatal outcome is unclear. The aim of the study was to determine if low and high concentrations of PAPP-A in the first trimester are related to perinatal outcome in twins. A retrospective study was conducted. Medical data of women in twin pregnancies who delivered between 2013 and 2018 were analyzed. PAPP-A concentrations were measured between 10 + 0 and 13 + 6 weeks. The associations between low (&lt;10th percentile) and high (&gt;90th percentile) values of PAPP-A and pregnancy complications were analyzed. A total of 304 patients were included. PAPP-A &lt;10th percentile was associated with a high risk of preterm delivery (OR 6.14; 95% CI 2.1\u201318), delivery &lt;34 weeks (OR 2.39; 95% CI 1.1\u20135.1) or &lt;32 weeks (OR3.06; 95% CI 1.4\u20136.8). Significant relations between PAPP-A &gt;90th percentile and delivery &lt;34 weeks (OR4.09; 95% CI 1.8\u20139.1) or &lt;32 weeks (OR 2.83; 95% CI 1.2\u20136.6) were found. PAPP-A &gt;90th percentile was related to high risk of intrauterine fetal demise (OR 10; 95% CI 2.4\u201342.5). Both low and high PAPP-A concentrations seem to be related to pregnancy outcome. Further research is needed to investigate evaluation of risk of pregnancy complications according to PAPP-A concentrations as a continuous variable.<\/jats:p>","DOI":"10.3390\/jcm9072099","type":"journal-article","created":{"date-parts":[[2020,7,6]],"date-time":"2020-07-06T09:49:11Z","timestamp":1594028951000},"page":"2099","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Both Low and High PAPP-A Concentrations in the First Trimester of Pregnancy Are Associated with Increased Risk of Delivery before 32 Weeks in Twin Gestation"],"prefix":"10.3390","volume":"9","author":[{"given":"Aleksandra","family":"Saletra-Bieli\u0144ska","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5461-273X","authenticated-orcid":false,"given":"Katarzyna","family":"Kosi\u0144ska-Kaczy\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland"},{"name":"Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, 01-809 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iwona","family":"Szymusik","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bartosz","family":"Kaczy\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics and Telemedicine, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5784-873X","authenticated-orcid":false,"given":"Robert","family":"Brawura-Biskupski-Samaha","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5492-0676","authenticated-orcid":false,"given":"Szymon","family":"Koz\u0142owski","sequence":"additional","affiliation":[{"name":"University Center for Woman and Newborn Health of the Medical University of Warsaw, 02-015 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrycja","family":"Jarmu\u017cek","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2908-0908","authenticated-orcid":false,"given":"Izabela","family":"Walasik","sequence":"additional","affiliation":[{"name":"Students Scientific Association at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miros\u0142aw","family":"Wielgo\u015b","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,7,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1080\/00016340802050668","article-title":"Term perinatal mortality and morbidity in monochorionic and dichorionic twin pregnancies: A retrospective study","volume":"87","author":"Lopriore","year":"2008","journal-title":"Acta Obstet. 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