Important Tests during pregnancy help check the baby's growth and health, as well as the mother's well-being.
Pregnancy-Associated Plasma Protein-A (PAPP-A): Pregnancy is a complex physiological process that needs a light balance of hormonal, metabolic, and immunological elements to guarantee the well-being of the mother and the developing embryo.
In that process, the Pregnancy-Associated Plasma Protein-A (PAPP A) plays a vital role. In recent years, it has collected significant attention for its role in pregnancy and likely as a biomarker in prenatal screening.
Learn About: Human Chorionic Gonadotropin (hCG)
This ultimate guide provides a comprehensive overview of PAPP-A. It includes meaning, Pregnancy plasma protein A normal range, function, clinical significance, PAPP A test, and more.
- What is Pregnancy Associated Plasma Protein A (PAPP-A)?
- What is the Role of PAPP-A in Pregnancy?
- PAPP-A as a Biomarker in Prenatal Screening
- What is the PAPP-A Test?
- When & How To Perform PAPP-A Test?
- Pregnancy-Associated Plasma Protein A Test Result
- What is meant by low pregnancy-associated plasma protein A?
- FAQs On Pregnancy-Associated Plasma Protein-a Down's Syndrome
What is Pregnancy Associated Plasma Protein A (PAPP-A)?
Pregnancy-associated plasma protein-A (PAPP-A) is a large glycoprotein with a molecular weight of approximately 200 kDa. In the 1970s, it was first defined as a protein considerably promoted in the maternal serum during pregnancy.
The placenta primarily produces PAPP-A but can also be found in other tissues such as the ovaries, endometrium, and decidua. This protein is part of the metzincin superfamily of metalloproteinases, which are enzymes that break down different components of the extracellular matrix.
Above all, PAPP-A is a protease that cleaves insulin-like growth factor-binding proteins (IGFBPs), particularly IGFBP-4.
What is the Role of PAPP-A in Pregnancy?
PAPP-A has a significant role in pregnancy, affecting several key processes vital for successful gestation. The primary function of PAPP-A is to control the availability of IGFs, which are critical for placental and fetal development.
Regulation of Fetal Growth:
PAPP-A is a substance that indirectly influences how IGFs work in the body. However, IGFs (Insulin-like Growth Factors) are essential for a baby's growth before birth.
When PAPP-A "splits" IGFBP-4, it makes more IGFs available for cells, which helps them develop, change, and dwell healthy. Low PAPP-A levels lead to a state called intrauterine growth restriction (IUGR). In IUGR, if the baby doesn't develop as much as anticipated in the uterus, it causes trouble during pregnancy and delivery.
Placental Function:
The placenta generates PAPP-A to manage IGF activity, assuring proper placental function for nutrient and oxygen transfer. Abnormal PAPP-A levels direct to placental insufficiency that leads to difficulties such as preeclampsia, preterm birth, or fetal demise.
Maternal Immune Tolerance:
The successful progress of pregnancy relies on a delicate equilibrium between the mother's immune system and the semi-allogeneic fetus. PAPP-A has been proposed to have a part in adjusting the maternal immune reaction, fostering immune acceptance of the growing fetus.
This state of immune tolerance is crucial for averting maternal rejection of the fetus, which could result in miscarriage or other unfavorable pregnancy consequences.
PAPP-A as a Biomarker in Prenatal Screening
PAPP-A is an important biomarker used in prenatal screening during the first trimester to assess the risk of chromosomal abnormalities like Down syndrome, Edwards syndrome, and Patau syndrome.
Normally. its levels are calculated in fusion with other markers namely free β-human chorionic gonadotropin (β-hCG) and nuchal translucency (NT).
First-Trimester Screening:
During the first trimester, low PAPP-A levels are related to an increased risk of trisomy 21 and other negative outcomes like preeclampsia, IUGR, and preterm birth. For this reason, PAPP-A evaluation is an integral part of first-trimester combined screening.
Mostly, the levels of PAPP-A are calculated between week 11 and week 14 of gestation. Together with pregnancy ultrasound markers and maternal age, these levels help determine the risk of chromosomal abnormalities, providing crucial information for further diagnostic testing or early intervention.
Pregnancy Complications:
Low PAPP-A levels can indicate pregnancy complications like preeclampsia, stillbirth, and placental issues. Observing the PAPP-A levels can help detect at-risk pregnancies early. Also, it may assist in anticipating other pregnancy complexities like gestational diabetes and fetal growth problems.
PAPP-A in Non-Pregnant Individuals:
PAPP-A has been extensively studied in non-pregnant individuals, particularly in cardiovascular diseases. Elevated PAPP-A levels have been conclusively associated with acute coronary syndrome and atherosclerosis, pointing out that this protein has broader implications beyond pregnancy. Ongoing research is focused on solidifying its role as a reliable biomarker for cardiovascular risk assessment.
What is the PAPP-A Test?
PAPP-A is also a hormone generated by the placenta during pregnancy. It can be detected by a blood test suggested between 11-14 weeks of pregnancy. The Pregnancy-Associated Associated Plasma Protein A test measures two hormones called Pregnancy-associated Plasma Protein A (PAPP-A) and Human Chorionic Gonadotropin (HCG).
With the help of the PAPP-A Test, doctors can easily identify the risks of genetic abnormalities in the fetus. This maternal blood test also comes under the part of the combined first-trimester screening. The objective of the PAPP-A pregnancy test is to prevent any genetic risks in the fetus at the early stage and help achieve a healthy baby birth.
When & How To Perform PAPP-A Test?
This PAPP-A Pregnancy Blood Test can be performed between the 11th week and the 14th week of pregnancy or at the end of the first trimester.
This prenatal screening test can be conducted in two ways - a blood test and an ultrasound scan. The tests of PAPP-A figure out the status of the developing fetus.
The ultrasound evaluates the nuchal translucency, which is the fluid accumulation under the skin behind the fetal neck. It also estimates the growth of the nasal bone to determine any potential abnormalities. Notably, this imaging procedure is completely non-invasive and safe for the fetus.
At the same time, the blood sample of the mother is taken to test the levels of Protein A and hCG. Both tests should be done on the same day to compare the fetal growth markers and levels of maternal biochemicals. Hence, PAPP-A is an important & early pregnancy test for the screening of chromosomal abnormalities.
PAPP-A Test Result
The result of the PAPP-A test displays various details such as maternal age, stage of pregnancy, and past obstetric history to measure the risk of genetic defects.
Mainly, the pregnancy-associated plasma protein A pregnancy test measures the levels of hCG and PAPP-A. It expresses via two values ie.,. MoM and Absolute Concentration.
The full form of MoM is a Multiple of the Median. When the MoM is 1.00, the result is average. >1.00 MoM value is higher than average and <1.00 means lower than average. Low PAPP-A means levels below 0.5 MoM, whereas 0.5 MoM or higher is the normal range of PAPP-A.
What is meant by low pregnancy-associated plasma protein A?
Low PAPP-A levels in pregnancy mean something is wrong in the placenta. As per the research studies, the levels of pregnancy-associated plasma protein A below 0.5 MoM in pregnant women may relate to:
- Fetal growth restriction.
- Increased chances of developing preeclampsia.
- Miscarriage or stillbirth in the second half of the pregnancy.
- Baby born with a lower weight.
- An increased chance of preterm birth.
If the PAPP-A test results in a low MoM value, a small dose of aspirin is suggested by the healthcare provider or doctors to stop the possible issues. Monitoring the levels of plasma protein A in pregnancy is the best preventive step and it comes under the first-trimester screening test.
FAQs On Pregnancy-Associated Plasma Protein-a Down's Syndrome
1. Is pregnancy plasma protein a PAPP-A Down syndrome?
Yes, pregnancy-associated plasma protein A (PAPP-A) is a hormone produced by the placenta during pregnancy and also acts as a biomarker for Down syndrome.
2. What is a normal PAPP-A level in pregnancy?
The (PAPP-A) Pregnancy-associated plasma Protein-A normal range is 0.5 MoM or higher.
3. What is the CPT code for pregnancy-associated plasma protein-a (PAPP-A)?
84163 is the Current Procedural Terminology (CPT) code for the pregnancy-associated plasma protein-A (PAPP-A) test.
4. What is PPA in Pregnancy?
PPA stands for Postpartum anxiety or pregnancy-associated plasma protein A in pregnancy. Both of them have different causes and effects during pregnancy. Stay tuned to our articles regularly and find the right meaning of PPA & Papp A
Conclusion
We hope the curated article on Pregnancy-Associated Plasma Protein-A (PAPP-A) helped you identify the growth of your fetus at the right time. It is more significant in predicting potential pregnancy complications like Down syndrome, preeclampsia, and fetal growth issues. So, monitoring PAPP-A levels is a must and it ensures timely interventions for healthier outcomes.
Lastly, we would appreciate it if you learn more or schedule your PAPP-A test during first-trimester pregnancy. Also, bookmark our site @Soumyahospitals.com and start learning more about Pregnancy week by week tests to ensure a safe and healthy pregnancy!