Low levels of PAPP-A concentrations in first trimester linked to development of Fibroids

Pregnant women who underwent a first-trimester aneuploidy screening test in a single tertiary centre between 2011 and 2020 were retrospectively assessed. One hundred ninety-eight women were found to have at least one noncavity distorting intramural uterine leiomyoma (Figo type 3–6) of at least 2 cm diameter and the remaining women were assigned as controls. First-trimester aneuploidy screening test parameters were compared.

Results:

Pregnancy associated plasma protein-A (PAPP-A) MoMs were found significantly lower in leiomyoma group in comparison to control group (1.19 ± 0.60 MoM vs. 1.40 ± 0.73 MoM, p = 0.002). PAPP-A MoMs in women with leiomyomas larger than 5.5 cm were significantly lower in comparison to both control group and women with ≤5.5 cm leiomyomas (0.82 ± 0.376 vs. 1.40 ± 0.73, p < 0.001; 0.82 ± 0.376 vs. 1.33 ± 0.61 p < 0.001, respectively). PAPP-A MoM and size of leiomyoma were found inversely correlated when fibroid size exceeds 5.5 cm (r = −0.467, p < 0.001).

Thus, Noncavity distorting intramural uterine leiomyomas >5.5 cm are associated with low first trimester PAPP-A MoMs (<0.5). PAPP-A concentrations are inversely correlated with fibroid size in women with >5.5 cm intramural uterine leiomyomas. Fibroids ≤5.5 cm are not associated with alterations in first trimester aneuploidy screening test parameters.

Reference:

Low first-trimester maternal serum PAPP-A concentrations in women with non-cavity-distorting intramural uterine fibroids by Alper Kahraman et al. published in the Journal of Obstetrics and Gynaecology Research.

https://doi.org/10.1111/jog.15188