What adverse outcome does a low level of Pregnancy Associated Plasma Protein A (PAPP-A) indicate?

A low level of Pregnancy Associated Plasma Protein A (PAPP-A) is associated with several adverse pregnancy outcomes, particularly fetal growth restriction. PAPP-A is a protein produced by the placenta, and it plays a critical role in regulating the availability of insulin-like growth factor (IGF), which is essential for fetal growth and development.

When PAPP-A levels are low, it indicates potential placental dysfunction, which can compromise the fetus's growth due to insufficient nutrient and oxygen delivery. This is particularly important during the first and second trimesters when fetal growth and development are most crucial.

Monitoring PAPP-A levels is often part of first-trimester screening for chromosomal abnormalities, and low levels have been correlated with an increased risk of intrauterine growth restriction (IUGR). While other factors like preterm labor, hypertension, and placental insufficiency can be involved in pregnancy outcomes, low PAPP-A specifically points more towards the likelihood of fetal growth restriction, making it an important marker to monitor during prenatal care.