Early Trimester Maternal Serum PAPP-A Levels Better Predicts Hypertensive Disorder Development

Hypertensive disorders during pregnancy are associated with elevated maternal and perinatal mortality and morbidity. The etiology of pregnancy-induced hypertension is likely rooted in placental factors – as glycoproteins such as β-hCG and PAPP-A are produced by the placenta.

A new study aimed to assess the predictive value of early trimester serum levels of β-hCG and PAPP-A for hypertensive disorder development during pregnancy.

This prospective cohort study was undertaken at IMS and SUM Hospital in Bhubaneswar. The research involved measuring maternal serum β-hCG and PAPP-A levels in singleton pregnant women at 11+0–13+6 weeks gestation. Follow-up was carried out until delivery to identify the occurrence of hypertension.

The mean maternal serum β-hCG value during 11-13 weeks gestation showed no correlation with the later development of hypertensive disorders. The mean serum β-hCG values for women who developed hypertensive disorders and those who did not were 48.13 ng/ml and 49.78 ng/ml, respectively. Meanwhile, the mean serum PAPP-A value for the normotensive group was 5.12 mIU/ml, and the value was 3.76 mIU/ml for women who developed hypertensive disorders.

Therefore, low maternal serum PAPP-A levels determined at 11+0–13+6 weeks demonstrated a more reliable predictive value for hypertensive disorder development during pregnancy compared to β-hCG.

Source: Sruthi R S, Sarita P, Marandi S. et al. J Obstet Gynecol India. 2024.