Low second trimester estimated fetal weight as a predictor of small-for-gestational age neonates in patients with low first trimester serum PAPP - A levels

Abstract

Objective: The aim of this study was to examine fetal growth in the second trimester and to detect its predictive value for delivering small-for- gestational age neonates in patients with low first trimester pregnancy associated plasma protein-A (PAPP-A) levels. Material and Methods: We searched the patient charts of our hospital for first trimester Down syndrome screening tests retrospectively (n=923), we identified patients with PAPP-A levels < 5th percentile (n=60) and then we searched their ultrasound records for second trimester estimated fetal weight (EFW) results (Hadlock) at 18-23 weeks. Results: The sensitivity of a low second trimester EFW for birth weights <5th percentile was 14.3%, specificity 90.7%, positive predictive value 33.3% and negative predictive value 76.4%. Conclusion: Combination of low second trimester EFW with low PAPP-A levels increase sensitivity and PPV of PAPP-A in detecting small-for-gestational age neonates. Copyright © 2013 by Tükiye Klinikleri.