Late pregnancy associated plasma protein A levels decrease in preterm labor.
Objective.â€ƒThe purpose of the present study is to evaluate late, 'at admission', Pregnancy-associated plasma protein-A (PAPP-A) levels as a predictor of preterm birth in women with complaints of preterm labor or preterm painful contractions. Methods.â€ƒProspective cohort study of singleton gestations, 23-37 weeks, and symptoms of preterm labor. Primary end point was deliveryâ€Š<â€Š37 weeks. Predictive PAPP-A values were calculated both for preterm delivery and threatened preterm delivery on receiver operator curve. Results.â€ƒIn all, 41 women (38.3%) delivered before 37 weeks (Group 1); 32 women (30.7%) had symptoms of preterm labor but did not deliver preterm (Group 2); 31 women (29.7%) delivered term (Group 3, control). Mean PAPP-A levels in preterm-labor and its matched control were 33.4â€ŠÂ±â€Š19.9 and 52.5â€ŠÂ±â€Š25.4â€‰mIU/ml, respectively, and difference was statistically significant (pâ€Š=â€Š0.003). Mean PAPP-A level in threatened preterm labor group was 47.6â€ŠÂ±â€Š25.3â€‰mIU/ml and difference was significant compared to preterm-labor, but not significant compared to control group (pâ€Š=â€Š0.028 and pâ€Š=â€Š0.74, respectively). Conclusion.â€ƒLate PAPP-A levels decreased in preterm labor, levelsâ€Š<â€Š29.8â€‰mIU/ml was associated with increased risk for preterm birth, supporting active management whereas cutoff value of 33.6â€‰mIU/ml is useful for discrimination of preterm birth from threatened preterm birth reaching to term.
Department of Obstetrics and Gynecology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
This article was published in the following journal.
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21557695
- DOI: http://dx.doi.org/10.3109/14767058.2010.531320
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Medical and Biotech [MESH] Definitions
A 6.6-kDa protein component of VERY-LOW-DENSITY LIPOPROTEINS; INTERMEDIATE-DENSITY LIPOPROTEINS; and HIGH-DENSITY LIPOPROTEINS. Apo C-I displaces APO E from lipoproteins, modulate their binding to receptors (RECEPTORS, LDL), and thereby decrease their clearance from plasma. Elevated Apo C-I levels are associated with HYPERLIPOPROTEINEMIA and ATHEROSCLEROSIS.
A product of the PLACENTA, and DECIDUA, secreted into the maternal circulation during PREGNANCY. It has been identified as an IGF binding protein (IGFBP)-4 protease that proteolyzes IGFBP-4 and thus increases IGF bioavailability. It is found also in human FIBROBLASTS, ovarian FOLLICULAR FLUID, and GRANULOSA CELLS. The enzyme is a heterotetramer of about 500-kDa.
Diabetes mellitus induced by PREGNANCY but resolved at the end of pregnancy. It does not include previously diagnosed diabetics who become pregnant (PREGNANCY IN DIABETICS). Gestational diabetes usually develops in late pregnancy when insulin antagonistic hormones peaks leading to INSULIN RESISTANCE; GLUCOSE INTOLERANCE; and HYPERGLYCEMIA.
An autosomal dominant disorder showing decreased levels of plasma protein S antigen or activity, associated with venous thrombosis and pulmonary embolism. PROTEIN S is a vitamin K-dependent plasma protein that inhibits blood clotting by serving as a cofactor for activated PROTEIN C (also a vitamin K-dependent protein), and the clinical manifestations of its deficiency are virtually identical to those of protein C deficiency. Treatment with heparin for acute thrombotic processes is usually followed by maintenance administration of coumarin drugs for the prevention of recurrent thrombosis. (From Harrison's Principles of Internal Medicine, 12th ed, p1511; Wintrobe's Clinical Hematology, 9th ed, p1523)
Removal of plasma and replacement with various fluids, e.g., fresh frozen plasma, plasma protein fractions (PPF), albumin preparations, dextran solutions, saline. Used in treatment of autoimmune diseases, immune complex diseases, diseases of excess plasma factors, and other conditions.