Evidence map›Paper›PMID 40468231›Full record

ArticleBMC pregnancy and childbirth2025

Study of first-trimester serum levels of β-hCG and PAPP-A as a screening test for fetal development of intrauterine growth restriction.

Ana Ceballos Medina, Inés Gómez-Acebo, Cristina Clare Gallego de Largy, Jessica Alonso-Molero, Silvia Vilares Calvo, Juan Manuel Odriozola Feu, María Ceballos Medina, Trinidad Dierssen-Sotos

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Article in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Ana Ceballos Medina *Department of gynaecology, Marqués de Valdecilla University Hospital, Santander, Spain.
Inés Gómez-Acebo *IDIVAL-Valdecilla Health Research Institute, Santander, Spain. ines.gomez@unican.es.
Cristina Clare Gallego de LargyDepartment of gynaecology, University Hospital of Burgos, Burgos, Spain.
Jessica Alonso-MoleroIDIVAL-Valdecilla Health Research Institute, Santander, Spain.
Silvia Vilares CalvoDepartment of gynaecology, Provincial Hospital of Pontevedra, Pontevedra, Galicia, Spain.
Juan Manuel Odriozola FeuDepartment of gynaecology, Marqués de Valdecilla University Hospital, Santander, Spain.
María Ceballos MedinaNursing department, Marqués de Valdecilla University Hospital, Santander, Spain.
Trinidad Dierssen-SotosIDIVAL-Valdecilla Health Research Institute, Santander, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the association between first-trimester serum levels of pregnancy-associated plasma protein-A (PAPP-A) and free beta-human chorionic gonadotropin (β-hCG) and the development of intrauterine growth restriction (IUGR), in order to assess their utility in early screening for improved perinatal outcomes.

methodsA retrospective case-cohort study was conducted at Marqués de Valdecilla University Hospital in 2021, including 119 pregnancies with IUGR and a randomly selected subcohort of 383 pregnancies from the same population. Serum levels of PAPP-A and β-hCG were analyzed both as continuous variables and as categorical variables based on population-specific percentiles (< 10th and < 5th). Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for relevant maternal and obstetric covariates.

resultsLower PAPP-A levels were significantly associated with an increased risk of IUGR, both as a continuous variable (OR = 0.50; 95% CI: 0.34-0.76, p = 0.001) and when categorized below the 10th percentile (OR = 4.01; 95% CI: 1.78-9.01, p < 0.001) and 5th percentile (OR = 4.45; 95% CI: 1.57-12.63, p = 0.005). β-hCG showed no association when analyzed continuously (p = 0.164), but values below the 10th percentile were significantly associated with IUGR (OR = 4.45; 95% CI: 1.97-10.04, p < 0.001). No reliable estimate could be obtained at the 5th percentile due to the small number of cases.

conclusionIncorporating PAPP-A and β-hCG into first-trimester screening protocols could enable earlier identification of pregnancies at risk of IUGR, facilitating timely interventions and potentially improving maternal and neonatal outcomes. These findings support the clinical utility of these biomarkers in routine obstetric care.

Indexed as

Chorionic Gonadotropin, beta Subunit, HumanFetal Growth RetardationPregnancy-Associated Plasma Protein-APregnancy Trimester, FirstAdultBiomarkersCase-Control StudiesFemaleHumansPregnancyRetrospective StudiesBiomarkersChorionic Gonadotropin, beta Subunit, HumanPAPPA protein, humanPregnancy-Associated Plasma Protein-AFirst-trimester screeningIntrauterine growth restrictionMaternal-fetal healthPAPP-APerinatal outcomesβ-hCG

Identifiers

PMID40468231
PMCPMC12135480

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.