Relationship between PAPP-A levels, placental morphometric parameters, and perinatal outcomes in pregnant women with fetoplacental insufficiency
DOI:
https://doi.org/10.15574/PP.2026.1(105).2733Keywords:
pregnancy-associated plasma protein A (PAPP-A), placental volume, fetal growth restriction, fetoplacental insufficiency, neonatal outcomesAbstract
Fetal growth restriction (FGR) and fetoplacental insufficiency (FPI) are major complications of pregnancy associated with adverse perinatal outcomes. Pregnancy-associated plasma protein A (PAPP-A) and placental morphometry have been proposed as potential predictors of fetal growth and neonatal health.
Aim - to evaluate the relationship between first-trimester PAPP-A, placental morphometry, and neonatal outcomes in pregnancies complicated by FPI and FGR, and to assess their predictive value for monitoring intrauterine growth.
Materials and methods. A prospective cohort study was conducted between 2023 and 2025. The study included 42 deliveries from women aged 20-40 years with FPI and FGR. Maternal and neonatal data were collected. Placental morphometry and PAPP-A were analyzed for correlation with neonatal outcomes. Statistical analyses included mean ± standard deviations, ranges, 95% confidence intervals, t-tests, analysis of variance (ANOVA), and Pearson/Spearman correlation coefficients.
Results. Gestational age ranged from 30+4 to 40+6 weeks. Preterm deliveries (<37 weeks) were less frequent and associated with lower birth weight (LBW) and Apgar scores. The mean birth weight was 3280±417 g, mean neonatal length 50.8±2.9 cm, mean placental volume 70.9±36.5 cm³, and mean PAPP-A 0.92±0.70 MoM. Reduced PAPP-A (<0.5 MoM) was associated with LBW (<2900 g) and smaller placental volume, whereas elevated PAPP-A (>1.5 MoM) corresponded to higher birth weight (>3700 g) and larger placental volume. PAPP-A positively correlated with birth weight and placental volume. Increased placental volume was also associated with greater neonatal length and mass.
Conclusion. PAPP-A levels and placental morphometric characteristics are significant predictors of fetal growth and neonatal outcomes in pregnancies complicated by FPI and FGR.
The research was carried out in accordance with the principles of the Declaration of Helsinki. The informed consent of the patients was obtained for conducting the studies.
The author declares the absence of conflict of interests.
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