Study of first-trimester serum levels of Beta-hCG and PAPP-A as a screening test for fetal development of intrauterine growth restriction

Objective: To evaluate the association between first-trimester serum levels of pregnancy-associated plasma protein-A (PAPP-A) and free beta-human chorionic gonadotropin (b-hCG) and the development of intrauterine growth restriction (IUGR), in order to assess their utility in early screening for impr...

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Authors: Ceballos Medina, María, Gómez Acebo, Inés, Clare Gallego de Largy, Cristina, Alonso Molero, Jessica, Vilares Calvo, Silvia, Odriozola Feu, Juan Manuel, Dierssen Sotos, Trinidad
Format: article
Publication Date:2025
Country:España
Institution:Universidad de Cantabria (UC)
Repository:UCrea Repositorio Abierto de la Universidad de Cantabria
Language:English
OAI Identifier:oai:repositorio.unican.es:10902/36616
Online Access:https://hdl.handle.net/10902/36616
Access Level:Open access
Keyword:Intrauterine growth restriction
First-trimester screening
PAPP-A
β-hCG
Maternal-fetal health
Perinatal outcomes
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spelling Study of first-trimester serum levels of Beta-hCG and PAPP-A as a screening test for fetal development of intrauterine growth restrictionCeballos Medina, MaríaGómez Acebo, InésClare Gallego de Largy, CristinaAlonso Molero, JessicaVilares Calvo, SilviaOdriozola Feu, Juan ManuelCeballos Medina, MaríaDierssen Sotos, TrinidadIntrauterine growth restrictionFirst-trimester screeningPAPP-Aβ-hCGMaternal-fetal healthPerinatal outcomesObjective: To evaluate the association between first-trimester serum levels of pregnancy-associated plasma protein-A (PAPP-A) and free beta-human chorionic gonadotropin (b-hCG) and the development of intrauterine growth restriction (IUGR), in order to assess their utility in early screening for improved perinatal outcomes. Methods: A retrospective case-cohort study was conducted at Marqués de Valdecilla University Hospital in 2021, including 119 pregnancies with IUGR and a randomly selected subcohort of 383 pregnancies from the same population. Serum levels of PAPP-A and b-hCG were analyzed both as continuous variables and as categorical variables based on population-specific percentiles (< 10th and < 5th). Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for relevant maternal and obstetric covariates. Results: Lower PAPP-A levels were significantly associated with an increased risk of IUGR, both as a continuous variable (OR = 0.50; 95% CI: 0.34-0.76, p = 0.001) and when categorized below the 10th percentile (OR = 4.01; 95% CI: 1.78-9.01, p < 0.001) and 5th percentile (OR = 4.45; 95% CI: 1.57-12.63, p = 0.005). b-hCG showed no association when analyzed continuously (p = 0.164), but values below the 10th percentile were significantly associated with IUGR (OR = 4.45; 95% CI: 1.97-10.04, p < 0.001). No reliable estimate could be obtained at the 5th percentile due to the small number of cases. Conclusion: Incorporating PAPP-A and b-hCG into first-trimester screening protocols could enable earlier identification of pregnancies at risk of IUGR, facilitating timely interventions and potentially improving maternal and neonatal outcomes. These findings support the clinical utility of these biomarkers in routine obstetric care.Springer NatureUniversidad de Cantabria20252025-01-01journal articlehttp://purl.org/coar/resource_type/c_6501NAhttp://purl.org/coar/version/c_be7fb7dd8ff6fe43info:eu-repo/semantics/articlehttps://hdl.handle.net/10902/36616BMC Pregnancy and Childbirth, 2025, 25(1), 655reponame:UCrea Repositorio Abierto de la Universidad de Cantabriainstname:Universidad de Cantabria (UC)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:repositorio.unican.es:10902/366162026-06-02T12:39:31Z
dc.title.none.fl_str_mv Study of first-trimester serum levels of Beta-hCG and PAPP-A as a screening test for fetal development of intrauterine growth restriction
title Study of first-trimester serum levels of Beta-hCG and PAPP-A as a screening test for fetal development of intrauterine growth restriction
spellingShingle Study of first-trimester serum levels of Beta-hCG and PAPP-A as a screening test for fetal development of intrauterine growth restriction
Ceballos Medina, María
Intrauterine growth restriction
First-trimester screening
PAPP-A
β-hCG
Maternal-fetal health
Perinatal outcomes
title_short Study of first-trimester serum levels of Beta-hCG and PAPP-A as a screening test for fetal development of intrauterine growth restriction
title_full Study of first-trimester serum levels of Beta-hCG and PAPP-A as a screening test for fetal development of intrauterine growth restriction
title_fullStr Study of first-trimester serum levels of Beta-hCG and PAPP-A as a screening test for fetal development of intrauterine growth restriction
title_full_unstemmed Study of first-trimester serum levels of Beta-hCG and PAPP-A as a screening test for fetal development of intrauterine growth restriction
title_sort Study of first-trimester serum levels of Beta-hCG and PAPP-A as a screening test for fetal development of intrauterine growth restriction
dc.creator.none.fl_str_mv Ceballos Medina, María
Gómez Acebo, Inés
Clare Gallego de Largy, Cristina
Alonso Molero, Jessica
Vilares Calvo, Silvia
Odriozola Feu, Juan Manuel
Ceballos Medina, María
Dierssen Sotos, Trinidad
author Ceballos Medina, María
author_facet Ceballos Medina, María
Gómez Acebo, Inés
Clare Gallego de Largy, Cristina
Alonso Molero, Jessica
Vilares Calvo, Silvia
Odriozola Feu, Juan Manuel
Dierssen Sotos, Trinidad
author_role author
author2 Gómez Acebo, Inés
Clare Gallego de Largy, Cristina
Alonso Molero, Jessica
Vilares Calvo, Silvia
Odriozola Feu, Juan Manuel
Dierssen Sotos, Trinidad
author2_role author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universidad de Cantabria
dc.subject.none.fl_str_mv Intrauterine growth restriction
First-trimester screening
PAPP-A
β-hCG
Maternal-fetal health
Perinatal outcomes
topic Intrauterine growth restriction
First-trimester screening
PAPP-A
β-hCG
Maternal-fetal health
Perinatal outcomes
description Objective: To evaluate the association between first-trimester serum levels of pregnancy-associated plasma protein-A (PAPP-A) and free beta-human chorionic gonadotropin (b-hCG) and the development of intrauterine growth restriction (IUGR), in order to assess their utility in early screening for improved perinatal outcomes. Methods: A retrospective case-cohort study was conducted at Marqués de Valdecilla University Hospital in 2021, including 119 pregnancies with IUGR and a randomly selected subcohort of 383 pregnancies from the same population. Serum levels of PAPP-A and b-hCG were analyzed both as continuous variables and as categorical variables based on population-specific percentiles (< 10th and < 5th). Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for relevant maternal and obstetric covariates. Results: Lower PAPP-A levels were significantly associated with an increased risk of IUGR, both as a continuous variable (OR = 0.50; 95% CI: 0.34-0.76, p = 0.001) and when categorized below the 10th percentile (OR = 4.01; 95% CI: 1.78-9.01, p < 0.001) and 5th percentile (OR = 4.45; 95% CI: 1.57-12.63, p = 0.005). b-hCG showed no association when analyzed continuously (p = 0.164), but values below the 10th percentile were significantly associated with IUGR (OR = 4.45; 95% CI: 1.97-10.04, p < 0.001). No reliable estimate could be obtained at the 5th percentile due to the small number of cases. Conclusion: Incorporating PAPP-A and b-hCG into first-trimester screening protocols could enable earlier identification of pregnancies at risk of IUGR, facilitating timely interventions and potentially improving maternal and neonatal outcomes. These findings support the clinical utility of these biomarkers in routine obstetric care.
publishDate 2025
dc.date.none.fl_str_mv 2025
2025-01-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
NA
http://purl.org/coar/version/c_be7fb7dd8ff6fe43
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/10902/36616
url https://hdl.handle.net/10902/36616
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Springer Nature
publisher.none.fl_str_mv Springer Nature
dc.source.none.fl_str_mv BMC Pregnancy and Childbirth, 2025, 25(1), 655
reponame:UCrea Repositorio Abierto de la Universidad de Cantabria
instname:Universidad de Cantabria (UC)
instname_str Universidad de Cantabria (UC)
reponame_str UCrea Repositorio Abierto de la Universidad de Cantabria
collection UCrea Repositorio Abierto de la Universidad de Cantabria
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.812429

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