Swart, S. (Sanne) (2016) Maternaal serum PAPP-A als diagnostische voorspeller voor groeivertraging tijdens de graviditeit. thesis, Medicine.
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Abstract
Objective: The aim of this study was to investigate the relationship between maternal serum pregnancy-associated plasma protein-A (PAPP-A) in the first trimester of pregnancy and the development of adverse pregnancy outcomes, like small for gestational age (SGA) and preeclampsia (PE). Method: This is a retrospective case control study of 435 singleton pregnancies that delivered between 2000 and 2016. There were 145 women with PAPP-A multiples of median (MoM) levels ≤ 0.3 and 290 women with PAPP-A MoM levels > 0.3 who served as a control group. Patients with risk factors for fetal growth restriction are excluded. Antepartum and delivery data were obtained by reviewing medical records. Outcome measures were SGA, gestational hypertension, preeclampsia, diabetes gravidarum, preterm delivery and neonatal survival. Independent T-test, Chi-square analysis, Fisher’s exact test, and the One-way Anova were used for statistical comparison of the two groups. Results: The two groups significantly differed for SGA (P10) fetus: 16.7% vs. 5.6%, p = 0.001, OR 3.40; SGA (P5) fetus: 10.8% vs. 3.6%, p = 0.008, OR 3.26; PE 9.7% vs. 2.4%, p = 0.011, OR 4.40, and prenatal death 9.6% vs. 1.4%, p = 0.000, OR 7.48. Growth restriction in history duplicate the change repeating growth restriction by a low PAPP-A (34.8% to 62.5%) Conclusion: maternal serum PAPP-A is a predictor for SGA and PE, but on its own, maternal serum PAPP-A performs poorly as a screening test for these conditions. Low PAPP-A duplicate the change for a SGA neonate. Therefore it is important to detect growth restriction prenatal, because these neonates have a fourfold lower risk for adverse outcome than those unrecognized. This test has a good prediction for an intra uterine demise when a woman has a low PAPP-A.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Facultair begeleider: and Duin, drs. LK and Prenatale diagnostiek, afdeling Gynaecologie en Obstetrie UM |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:05 |
| Last Modified: | 25 Jun 2020 11:05 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2492 |
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