PAPP-A Levels and IGF-1 Levels in Early-Onset Preeclampsia and Late-Onset Preeclampsia
(1) Residen of Departement of Obstetrics and Gynecology, RSUP Dr. M. Djamil, Padang, Indonesia;
(2) Sub Division of Fetomaternal Medicine, Obstetrics and Gynecology Department, Faculty of Medicine, Andalas University, Dr. M. Djamil Central General Hospital Padang, West Sumatera, Indonesia
(3) Sub Division of Fetomaternal Medicine, Obstetrics and Gynecology Department, Faculty of Medicine, Andalas University, Dr. M. Djamil Central General Hospital Padang, West Sumatera, Indonesia
(*) Corresponding Author
DOI: https://doi.org/10.25077/aoj.8.1.525-530.2024
Abstract
Introduction: The pathophysiology of preeclampsy is not yet fully understood, but failure of tropoblast
invasion and placentation, which is influenced by factors such as pregnancy-associated plasma protein
A (PAPP-A) and insulin-like growth factor 1 (IGF-1), is thought to play a role.
Aims: This study aimed to explore the difference in PAPP-A and IGF-1 levels between Early Onset
Preeclampsia (PEAD) and Late Onset Preeclampsia (PEAL) assuming that the role of PAPP-A and
IGF-1 is more significant in the pathogenesis of PEAD than PEAL.
Methods: This is an analytical observational study with a cross-partition comparative study design.
Clinical data were obtained at Dr. M. Djamil Padang Hospital, while PAPP-A and IGF-1 levels were
measured at the Biomedical Laboratory of the Faculty of Medicine, Andalas University. Samples are
tested according to reagent procedures and analyzed by experts.
Results: Average PAPP-A levels were 2.45+0.35 pg/mL in the early onset preeclampsy group and
2.85+0.50 pg/mL in the late onset preeclampsy group. These two levels differed statistically
significantly (p=0.006). That means that low levels of PAPP-A are associated with and play a role in
the pathogenesis of early onset preeclampsy. Average IGF-1 levels were 4.66+0.91 pg/mL in the early
onset preeclampsy group and 5.39+0.74 pg/mL in the late-onset preeclampsy group. These two levels
differed statistically significantly (p=0.010). That means that low levels of IGF-1 are associated with
and play a role in the pathogenesis of early onset preeclampsy. PAPP-A levels were significantly
positively correlated with IGF-1 levels (p=0.000).
Conclusion: PAPP-A levels are lower in PEAD than PEAL, as are IGF-1 levels. These findings confirm
the role of PAPP-A and IGF-1 in preeclampsia. Both of these hormones have potential as indicators
and markers for the prediction and management of preeclampsy in early and late onset periods.
Keywords
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Ives CW, Sinkey R, Rajapreyar I, Tita ATN, Oparil S. Preeclampsia-Pathophysiology and
Clinical Presentations: JACC State-of-the-Art Review. J Am Coll Cardiol. 2020 Oct
;76(14):1690-1702.
Yang Y, Le Ray I, Zhu J, Zhang J, Hua J, Reilly M. Preeclampsia Prevalence, Risk Factors,
and Pregnancy Outcomes in Sweden and China. JAMA Netw Open. 2021 May
;4(5):e218401.
Mayrink J, Souza RT, Feitosa FE, Rocha Filho EA, Leite DF, Vettorazzi J, Calderon IM,
Sousa MH, Costa ML, Baker PN, Cecatti JG; Preterm SAMBA study group. Incidence and
risk factors for Preeclampsia in a cohort of healthy nulliparous pregnant women: a nested
case-control study. Sci Rep. 2019 Jul 2;9(1):9517.
Belay AS, Wudad T. Prevalence and associated factors of pre-eclampsia among pregnant
women attending anti-natal care at Mettu Karl referal hospital, Ethiopia: cross-sectional
study. Clin Hypertens. 2019 Jul 1;25:14.
Mendes S, Timóteo-Ferreira F, Almeida H, Silva E. New Insights into the Process of
Placentation and the Role of Oxidative Uterine Microenvironment. Oxid Med Cell Longev.
Jun 25;2019:9174521.
Yu N, Cui H, Chen X, Chang Y. First trimester maternal serum analytes and second trimester
uterine artery Doppler in the prediction of preeclampsia and fetal growth restriction. Taiwan J
Obstet Gynecol. 2017 Jun;56(3):358-361.
Zhou W, Wang H, Yang J, Long W, Zhang B, Liu J, Yu B. Down-regulated circPAPPA
suppresses the proliferation and invasion of trophoblast cells via the miR-384/STAT3
pathway. Biosci Rep. 2019 Sep 6;39(9):BSR20191965.
Fruscalzo A, Cividino A, Rossetti E, Maurigh A, Londero AP, Driul L. First trimester PAPP-
A serum levels and long-term metabolic outcome of mothers and their offspring. Sci Rep.
Mar 20;10(1):5131.
Keikkala E, Forstén J, Ritvos O, Stenman UH, Kajantie E, Hämäläinen E, Räikkönen K, Villa
PM, Laivuori H. Serum Inhibin-A and PAPP-A2 in the prediction of pre-eclampsia during the
first and second trimesters in high-risk women. Pregnancy Hypertens. 2021 Aug;25:116-122.
Wrigley S, Arafa D, Tropea D. Insulin-Like Growth Factor 1: At the Crossroads of Brain
Development and Aging. Front Cell Neurosci. 2017 Feb 1;11:14.
Ma M, Zhou QJ, Xiong Y, Li B, Li XT. Preeclampsia is associated with hypermethylation of
IGF-1 promoter mediated by DNMT1. Am J Transl Res. 2018 Jan 15;10(1):16-39.
Aksornphusitaphong A, Phupong V. Risk factors of early and late onset pre-eclampsia. J
Obstet Gynaecol Res. 2013 Mar;39(3):627-31.
Markin L, Medvyedyeva O. Early-versus late-onset preeclampsia: differences i risk factors
and birth outcomes. Lviv clinical bulletin 2017, 4(20).
Gomathy E, Akurati L and Radhika K. Early onset and late onset preeclampsia-maternal and
perinatal outcomes in rural tertiary health ceenter. Int J Reprod Contracept Obstet Gyneol.
Jun; 7(6):2266-2269.
Redman CW. Eearly and late onset preeclampsia: Two sides of the same coin. J.preghy.
;7:58
Staff AC and Redman CWG. The difference between Early- and Late-Onset Preecclampsia.
Comprehensive Gynecology and Obstetrics book series (CGO). 2017.
Oxvig C. The role of PAPP-A in the IGF system: location, location, location. J Cell Commun
Signal. 2015 Jun; 9(2): 177–187.
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