The relation of first trimester PaPP-A level and vaginal birth complications in large for gestational age fetuses

Abstract

Aim: To investigate the association of vaginal birth complications with first trimester pregnancy associated plasma protein A (PaPP-A) level in LGA vaginal deliveries of non-diabetic mothers. Methods: This is a retrospective study conducted in a tertiary hospital between May 2020 and July 2022. A total of 9,184 singleton pregnancies with normal vaginal delivery between 37 and 42 weeks were reviewed. Non- diabetic patients who gave birth to LGA infants were grouped according to the presence of vaginal birth complications and compared in terms of first trimester aneuploidy screening results. Regression analysis was used to investigate the effect of variables on complications. Receiver operating characteristic (ROC) analysis was performed for the threshold PaPP-A value to predict birth complications. Results: Of the 357 patients, 68 (19.0%) had at least one complication, remaining 289 (81.0%) had no complications. First trimester serum PaPP-A level was significantly higher in complicated group than patients without complications (20.85 ± 19.73 vs 15.18 ± 15.81, p=0.046). First trimester NT, B-hCG and PaPP-A are significantly associated with perinatal complications in LGA vaginal deliveries. The cut-off value of first trimester PaPP-A level was 10.46 mIU/mL to predict the complications with a sensitivity of 54.4% and a specificity of 54.3%.