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J Matern Fetal Neonatal Med. 2016 Sep;29(18):2962-7. doi: 10.3109/14767058.2015.1109622. Epub 2015 Dec 15.

Predicting SGA neonates using first-trimester screening: influence of previous pregnancy's birthweight and PAPP-A MoM.

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a Praenatal-Medizin Und Genetik Düsseldorf , Düsseldorf, NRW , Germany and.
b Coordination Center for Clinical Trials, University of Düsseldorf , Düsseldorf, NRW , Germany.



Investigating the proportions of anamnestic and biochemical variables of the previous and current pregnancies for the prediction of small for gestational age (SGA) neonates in the current pregnancy.


In this observational retrospective study, 45 029 pregnancies were examined, including 3862 patients with more than one pregnancy. Odds ratios for SGA using anamnestic parameters and pregnancy-associated plasma protein A (PAPP-A) values from all pregnancies were estimated by using a logistic regression model.


There were 2552 (5.7%) SGA neonates. Two threshold PAPP-A values were identified at 0.15 MoM and 0.33 MoM with probabilities for SGA of 23% and 17%, respectively. A previous SGA < 10th centile and a current PAPP-A MoM value < 5th centile result in odds ratios of 4.8 (95% CI: 3.5-6.5) and 3.0 (95% CI: 1.8-5.0), respectively. The parameters' combined odds ratio is 14.1 (95% CI: 3.9-50.3) with a number needed to screen of ten for one SGA neonate at a detection rate of 37%.


Information on previous pregnancies affected by SGA and a current pregnancy's low PAPP-A value are reliable predictors for a SGA delivery. First-trimester biochemical analysis should be maintained to detect women at risk for delivering a SGA neonate.


Maternity care; obstetrics; prenatal diagnosis

[Indexed for MEDLINE]

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