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OP25.07: Outcome of low PAPP‐A pregnancies in a community‐based first trimester screening program

Objectives: To follow up pregnancies with low PAPP-A (less than 0.3 multiples of the mean) in first-trimester screening once chromosome anomalies are excluded. Methods: Outcomes by data linkage of pregnancies of all Fetal Medicine Foundation approved centers for the entire state screened by both ultrasound nuchal translucency and free βhCG and PAPPA correlated with birth data required for all births in Western Australia. Results: Over 10 000 women were screened, with outcome data for 98.4%. The first percentile for PAPP-A in this population was 0.27. Women with low PAPP-A were more likely to have preterm birth, low birth weight and pregnancy loss. There was not a higher incidence of non-chromosomal birth defects. As a screen for nonchromosomal and non-birth-defect adverse outcomes, low PAPP-A had only a 5% sensitivity. Conclusions: Low PAPP-A may highlight pregnancies at increased risk of adverse outcome but it not sufficiently sensitive for population screening.