What is PAPP-A

The PAPP-A bloods are an optional blood test taken at your first scan as part of the Genetic Screening.

PAPP-A means Pregnancy Associated Plasma Protein and its looking at type A.

It is thought that having low levels of this protein can affect the health of both you and your baby in various ways.

It seems that low levels of PAPP-A have been associated with an increased risk of developing Pre-Eclampsia which is often associated with high blood pressure in the second half of your pregnancy and can lead to Eclampsia, which is when the condition gets out of control.  (This is extremely rare, as your blood pressure is monitored often at the end of pregnancy)

PAPP-A affects how the placenta works and low levels can increase the risk of Intra Uterine Growth Restriction (IUGR).  This is when a baby does not grow as expected and will often lead to your baby needing extra support from the Neonatal Team.

Note: IUGR is very different from growing a small baby.   Some babies are just small, think about how large you were at birth, the size of your sisters, mother, grandmother's babies… this is often a good indication of the size of baby you can expect.  I’m 4’11, my babies ranged from 5lbs 12 to 6lbs 10.  I was 5lbs 4 when I was born.    I would not have been worried about a small baby per se, but I would have been worried if there was a diagnosed IUGR as this affects development as well as size.  Working out what is normal for you and your family is important, when you are making decisions about your baby’s early eviction from the womb.

Low PAPP-A levels have been seen in preterm birth and some studies report a slight increased risk of stillbirth and we can see from the research that this is often associated with an abnormal placenta.  It is always worth knowing what the actual risks are for you, whether there are other risk factors as well as the low PAPP-A bloods.  Our bodies don’t often get it wrong. 

It is important to note that blood results indicating a low PAPP-A do not necessarily mean that these complications will occur for you.  Many women with low levels of PAPP-A have perfectly healthy pregnancies.  You will probably be offered increased scans and extra monitoring in the second half of your pregnancy and it is up to you whether you choose to accept this extra monitoring or not.