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First trimester PAPP-A2, PAPP-A and hCGβ in small-for-gestational-age pregnancies

  • Young Bae Hansen ORCID logo EMAIL logo , Vibeke Myrhøj , Finn Stener Jørgensen , Claus Oxvig and Steen Sørensen
Published/Copyright: May 12, 2015
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 54 Issue 1

Abstract

Background: Pregnancy-associated plasma protein-A2 (PAPP-A2) is a recently discovered protease that cleaves a subset of insulin-like growth factor binding proteins (IGFBP). The molecular function suggests its involvement in the IGF system that is vital for fetal growth and development. Our objectives were to establish first trimester median curves of PAPP-A2, PAPP-A and hCGβ for singleton normal pregnancies and to investigate whether an altered level of one or more of the biomarkers is associated with small-for-gestational-age (SGA) neonates before and after stratification according to maternal hypertension and/or proteinuria.

Methods: This was a case-control study based on 985 pregnant women delivering normal-weighted neonates and 170 pregnant women delivering SGA neonates. PAPP-A2 was measured by ELISA. PAPP-A and hCGβ were measured by an automatic analyzer. Median curves from 8+1 to 14+0 were established and all concentration values were converted to multiples of the median (MoM) values.

Results: Before stratification the SGA cases had unaffected PAPP-A2 MoM and hCGβ MoM levels but lower PAPP-A MoM compared with normal controls. After stratification the SGA normotensive subgroup had lower PAPP-A2 MoM and PAPP-A MoM levels than the normal normotensive subgroup. Severe preeclamptic women delivering SGA neonates had higher PAPP-A2 MoM compared to the normotensive women delivering SGA neonates.

Conclusions: Pregnant women delivering SGA neonates did not have altered levels of PAPP-A2 or hCGβ but had lower PAPP-A level in the first trimester compared with pregnant women delivering normal-weighted neonates. Pregnancies complicated with severe preeclampsia and SGA may be associated with high PAPP-A2 level.

Keywords: first trimester biomarker; preeclampsia; pregnancy-associated plasma protein-A2 (PAPP-A2); small-for-gestational-age
Corresponding author: Young Bae Hansen, Department of Clinical Biochemistry, Copenhagen University Hospital Hvidovre, Kettegaard Alle 30, 2650 Hvidovre, Denmark, E-mail: , http://orcid.org/0000-0002-8428-560X; and Department of Clinical Biochemistry, Copenhagen University Hospital Glostrup, Denmark

Acknowledgments

We thank AnshLabs, Webster, TX, USA for their kind donation of the PAPP-A2 assays. Also, we thank Dr. Carsten Nickelsen, MD, DMSc. and Steen Rasmussen, Senior Advisor, M.Sc. for helping with the data collection.

  1. Author contributions:All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership:Claus Oxvig is an inventor on patent US7083940 relating to measurement of PAPP-A2.

  4. Honorarium: None declared.

  5. Competing interests:The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2015-3-5
Accepted: 2015-4-4
Published Online: 2015-5-12
Published in Print: 2016-1-1

©2016 by De Gruyter

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https://doi.org/10.1515/cclm-2015-0230
Keywords for this article
first trimester biomarker; preeclampsia; pregnancy-associated plasma protein-A2 (PAPP-A2); small-for-gestational-age

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Building a bridge to safe diagnosis in health care. The role of the clinical laboratory
  4. Capillary electrophoresis for the screening and diagnosis of inherited hemoglobin disorders. Ready for prime time?
  5. Reviews
  6. Hyperuricemia as risk factor for coronary heart disease incidence and mortality in the general population: a systematic review and meta-analysis
  7. Towards biomarker-based tests that can facilitate decisions about prevention and management of preeclampsia in low-resource settings
  8. Mini Review
  9. Clinical relevance of sST2 in cardiac diseases
  10. General Clinical Chemistry and Laboratory Medicine
  11. Preservation of urine free catecholamines and their free O-methylated metabolites with citric acid as an alternative to hydrochloric acid for LC-MS/MS-based analyses
  12. Performance characteristics of the VIDAS® 25-OH Vitamin D Total assay – comparison with four immunoassays and two liquid chromatography-tandem mass spectrometry methods in a multicentric study
  13. Differentiation of acute pyelonephritis from other febrile states in children using urinary neutrophil gelatinase-associated lipocalin (uNGAL)
  14. Early postoperative C-terminal agrin fragment (CAF) serum levels predict graft loss and proteinuria in renal transplant recipients
  15. Homocitrulline: a new marker for differentiating acute from chronic renal failure
  16. Hematology and Coagulation
  17. Development of hemoglobin typing control materials for laboratory investigation of thalassemia and hemoglobinopathies
  18. Comparison of capillary electrophoresis and high performance liquid chromatography for detection and quantification of hemoglobin New York
  19. Prevalence of hemostatic alterations in patients with recurrent spontaneous subconjunctival hemorrhage
  20. Reference Values and Biological Variations
  21. Reference intervals for 24 laboratory parameters determined in 24-hour urine collections
  22. First trimester PAPP-A2, PAPP-A and hCGβ in small-for-gestational-age pregnancies
  23. Cancer Diagnostics
  24. Clinical utility of one versus two faecal immunochemical test samples in the detection of advanced colorectal neoplasia in symptomatic patients
  25. Cardiovascular Diseases
  26. Time from symptom onset influences high-sensitivity troponin T diagnostic accuracy for the diagnosis of acute myocardial infarction
  27. Prognostic significance of serum albumin level changes in acute ischemic stroke: the role of biological and analytical variation
  28. Correlates of serum hepcidin levels and its association with cardiovascular disease in an elderly general population
  29. Infectious Diseases
  30. Usefulness of several biomarkers in the management of septic patients: C-reactive protein, procalcitonin, presepsin and mid-regional pro-adrenomedullin
  31. Diabetes
  32. Performance of strip-based glucose meters and cassette-based blood gas analyzer for monitoring glucose levels in a surgical intensive care setting
  33. Accuracy and precision assessment of a new blood glucose monitoring system
  34. Acknowledgment
  35. Acknowledgment
  36. Letter to the Editors
  37. Glypican-1 as a highly sensitive and specific pancreatic cancer biomarker
  38. Platelet microRNAs are not modulated by systemic heparin in acute coronary syndromes
  39. Concomitant appearance of two false positive peaks with a true monoclonal one in a patient with plasma cell myeloma
  40. Anti-streptavidin interferences in Roche thyroid immunoassays: a case report
  41. Evaluation of the new Methotrexate CMIA assay on the Architect i2000SR
  42. Liposomal interference on Sysmex XN-series body fluid mode
  43. Development of an immunomagnetic beads-based test and its application in influenza surveillance
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