Association between adverse pregnancy outcome and placental biomarkers in the first trimester: a prospective cohort study

Objective: To determine the inter-relationships between five first trimester biomarkers (pregnancy associated plasma protein A [PAPP-A], alpha-fetoprotein [AFP], beta human chorionic gonadotrophin [beta-hCG], placenta growth factor [PlGF] and soluble fms-like tyrosine kinase receptor-1 [sFlt-1]) and a range of adverse pregnancy outcomes (APOs). Design: Prospective cohort study of nulliparous singleton pregnancy. Setting: Cambridge, UK. Population or Sample: 4056 Pregnancy Outcome Prediction study participants. Methods: The biomarker concentrations were measured in maternal serum at ~12 weeks of gestation. Univariable analysis of APOs was performed using logistic regression. Multivariable analysis used best subsets logistic regression with cross-validation. Main Outcome Measures: Pre-eclampsia (PE), small for gestational age (SGA), including severe SGA (birth weight