First-trimester prediction of early-onset preeclampsia using PAPP-A and mean arterial pressure

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dc.authorid0000-0002-0933-7764
dc.authorid0000-0002-7063-0783
dc.authorid0009-0001-8439-7142
dc.authorid0000-0001-6925-711X
dc.authorid0000-0002-8548-124X
dc.contributor.authorBeyazit, Fatma
dc.contributor.authorPek, Eren
dc.contributor.authorDas, Murat
dc.contributor.authorDuran, Mehmet Nuri
dc.contributor.authorCakir, Dilek Ulker
dc.contributor.authorSen, Basak Nil
dc.contributor.authorKiraz, Hasan Ali
dc.date.accessioned2026-02-03T12:00:21Z
dc.date.available2026-02-03T12:00:21Z
dc.date.issued2025
dc.departmentÇanakkale Onsekiz Mart Üniversitesi
dc.description.abstractPredicting early-onset preeclampsia (EOP) during the initial stages of pregnancy is essential for effective clinical management and enhancing maternal-fetal outcomes. Current methodologies, which include clinical and demographic risk factors, biophysical parameters, and serum biomarkers, exhibit limited efficacy in predicting EOP. This study aimed to evaluate whether the incorporation of pregnancy-associated plasma protein-A (PAPP-A) and mean arterial pressure (MAP) significantly enhances EOP detection. We conducted a retrospective case-control study involving 518 gravidas, of whom 202 developed EOP and 316 experienced normal pregnancies. Logistic regression models were employed to assess EOP predictions, and the predictive accuracy of these statistical models was evaluated using receiver-operating characteristic curve analysis. Our findings indicate that lower PAPP-A levels, higher MAP, and increased body mass index (BMI) are associated with EOP. Notably, in pregnant women at 11-13+6 weeks of gestation, a 1-point decrease in PAPP-A corresponds to an 84% increase in the likelihood of developing EOP. The predictive performance of PAPP-A improves significantly when combined with other factors such as BMI, MAP, and a history of diabetes mellitus (DM). The risk of EOP is substantially heightened (20.410 times, 95% CI: 11.104-37.515) in patients exhibiting low PAPP-A levels (<0.88) and high BMI (>= 35 kg/m2). Additionally, low PAPP-A combined with elevated MAP levels significantly increases EOP risk (adjusted odds ratio [OR]: 114.83). However, after adjustment, the association between low PAPP-A and a history of DM was not statistically significant (adjusted OR: 2.30, p = 0.202). In conclusion, employing a combination of multiple variables for predicting EOP yields a significant improvement over traditional methods that rely solely on individual factors.
dc.identifier.doi10.17305/bb.2025.12814
dc.identifier.endpage2809
dc.identifier.issn2831-0896
dc.identifier.issn2831-090X
dc.identifier.issue12
dc.identifier.pmid40706556
dc.identifier.scopus2-s2.0-105016597598
dc.identifier.scopusqualityQ1
dc.identifier.startpage2801
dc.identifier.urihttps://doi.org/10.17305/bb.2025.12814
dc.identifier.urihttps://hdl.handle.net/20.500.12428/34571
dc.identifier.volume25
dc.identifier.wosWOS:001537528100001
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherAssoc Basic Medical Sci Federation Bosnia & Herzegovina Sarajevo
dc.relation.ispartofBiomolecules and Biomedicine
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_WOS_20260130
dc.subjectPrediction
dc.subjectpreeclampsia
dc.subjectpregnancy
dc.subjectPAPP-A
dc.subjecthypertension
dc.titleFirst-trimester prediction of early-onset preeclampsia using PAPP-A and mean arterial pressure
dc.typeArticle

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