The relationship of PAPP-A and ß-HCG values with fetal gender and fetal birth weight: A single-center experience

Background/Aim: Intrauterine growth restriction (IUGR) is a multisystem disorder that results in perinatal morbidity and mortality due to decreased oxygen transfer from mother to fetus, a consequence of placental dysfunction. The placenta secretes certain unique proteins, the levels of which significantly rise in maternal blood during pregnancy. Among these, free beta-human chorionic gonadotropin (ß-HCG) and Pregnancy-Associated Plasma Protein-A (PAPP-A) are the most frequently analyzed. Our primary aim was to assess the correlation between PAPP-A and free ß-HCG levels, derived from the first-trimester dual-screening test, with fetal sex and birth weight. Our secondary aim was to determine the possibility of predicting IUGR using these markers. Methods: The first-trimester screening data, along with fetal sex and birth weight, of singleton pregnancies in either primiparous or multiparous women who attended Istanbul Koşuyolu Medipol Hospital and gave birth during the first trimester, were retrospectively analyzed from the hospital file system. Results: PAPP-A demonstrated a positive correlation with birth weight. It was significantly lower in cases of IUGR compared to normal fetal birth weight. A statistically significant correlation was also found between fetal gender and both ß-HCG and PAPP-A values; they were both higher in girls compared to boys (P<0.05). Conclusions: Pregnancies with low PAPP-A values in first-trimester screenings should be closely monitored for IUGR. As PAPP-A and ß-HCG averages were found to be lower in boys, they appear more risky. At this point, a larger number of multicentric prospective studies are needed to support this conclusion.