Introduction Maternal serum pregnancy associated plasma protein A (PAPP-A) is derived from the placenta and is a component of combined screening. When combined with maternal age, fetal nuchal translucency and maternal serum free β-hCG it has a detection rate of 85–90% for trisomy 21 (1). PAPP-A levels are influenced by other factors including ethnicity, smoking status and mode of conception (e.g. IVF). Previous studies have correlated low PAPP-A with adverse pregnancy outcomes including pre-eclampsia, pregnancy induced hypertension, small for gestational neonates and late pregnancy losses (1,2,3).

Aims We identified cases of low PAPP-A at our university hospital to review pregnancy outcomes.

Methods We conducted a retrospective study of the case notes of 64 women with a PAPP-A level less than 1.0 MoMs who had high risk combined screening results.

Results Twenty-six women had a PAPP-A of ≤0.5 MoMs and thirty-eight women had a PAPP-A of 0.5-≤1.0 MoMs. Table 1 summarises our findings.

Figure 1 illustrates the relationship between maternal PAPP-A and birth weight of the baby

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Abstract PPO.45 Figure 1

Conclusion Low PAPP-A levels were associated with an increase in adverse pregnancy outcomes. 14% of the patients in our study had small for gestational age babies. As expected the chromosomal anomaly rate in our group was much higher than the background rate.

Reference Fetal Medicine Foundation. The 11–13 Week Scan [Online]. Available at: https://courses.fetalmedicine.com/fmf/