Determination of the prerequisites for fetal macrosomia using biomarkers in the first trimester of pregnancy

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Abstract

Low levels of maternal serum PAPP-A in the first trimester of pregnancy are associated with an increased risk of developing fetal growth restriction and/or low-weight fetuses. There is evidence of a correlation between the blood plasma concentration of PAPP-A in a pregnant woman and the weight of the fetus in the 1st, 2nd, and 3rd trimesters. However, when studying the relationship between PAPP-A and/or β-hCG and the birth of a large fetus, the data are contradictory, highlighting the need for further research to clarify the possibility of predicting fetal macrosomia.

Objective: To determine the relationship between prenatal screening indicators in the first trimester and the development of a large fetus.

Materials and methods: This retrospective cohort study included 408 healthy primiparas. The patients were divided into a study group (n=298), including newborns weighing up to 4000 g, and a control group (n=110), including newborns weighing 4000 g or more. In the first trimester, the levels of β-hCG, PAPP-A, and PIGF in the blood serum were assessed using an enzyme immunoassay.

Results: The data obtained showed that the levels of PAPP-A (MoM) were 1.08 versus 1.2 (p=0.04), PIGF (pg/ml) 21.18 versus 25 (p=0.008), and PIGF (MoM) 0.78 versus 0.85 (p=0.04), which was significantly higher in the group with large fetuses. Additionally, there was a direct correlation between the studied markers and birth weight.

Conclusion: The data obtained demonstrated the formation of associations with the development of macrosomia as early as the first wave of trophoblast invasion. However, its realization apparently requires a combination of predisposing factors.

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About the authors

Oleg V. Tysyachnyi

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Author for correspondence.
Email: o_tysyachny@oparina4.ru
ORCID iD: 0000-0001-9282-9817

Ph.D., Researcher at the 1st Maternity Department

Russian Federation, 117997, Moscow, Oparina str., 4

Oleg R. Baev

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: metod_obsgyn@hotmail.com
ORCID iD: 0000-0001-8572-1971

Dr. Med. Sci., Professor, Head of the Maternity Department, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, Professor of the Department of Obstetrics, Gynecology, Perinatology, and Reproductology, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia

Russian Federation, 117997, Moscow, Ac. Oparina str., 4; 119991, Moscow, Trubetskaya str., 8-2

Anna O. Zimina

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: anne-89@mail.ru
ORCID iD: 0000-0001-8555-144X

PhD, Teaching Assistant at the Department of Obstetrics and Gynecology of the Department of Professional Education, obstetrician-gynecologist of the 1st Maternity Department

Russian Federation, 117997, Moscow, Oparina str., 4

Lubov V. Krechetova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: k_l_v_@mail.ru
ORCID iD: 0000-0001-5023-3476

Dr. Med. Sci., Head of the Laboratory of Clinical Immunology

Russian Federation, 117997, Moscow, Oparina str., 4

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