The Relationship Between Serum Hcy and PAPP-A Levels and Fetal Growth Restriction in Preeclampsia

WEI Mengyao; ZHAO Ruizhen; LI Zihan; SHI Guosu; HU Xiaoli

doi:10.3639/j.issn.2095-3097.2025.10.004

Abstract：Objective To investigate the relationship between serum homocysteine(Hcy)and pregnancy-associated plasma protein-A(PAPP-A)levels and fetal growth restriction(FGR)in patients with preeclampsia(PE).Methods A total of 116 patients with PE who were admitted to Xingtai Central Hospital from October 2022 to October 2024 were retrospectively selected and categorized into an FGR group(n=35)and a non-FGR group(n=81)based on the occurrence of FGR.Serum levels of Hcy and PAPP-A,as well as clinical data,were collected and compared between the two groups.Multivariate logistic regression analysis was used to analyze the influencing factors for FGR in PE patients,and receiver operating characteristic(ROC)curves were plotted to evaluate the predictive value of Hcy and PAPP-A for FGR.Results Among the 116 PE patients,the incidence of FGR was 30.17%(35/116).The FGR group had higher serum Hcy levels,uric acid levels,and 24-hour total urine protein than the non-FGR group(P<0.05),while PAPP-A levels,fetal biparietal diameter,and fetal femur length were lower than those in the non-FGR group(P<0.05).Multivariate logistic regression analysis showed that Hcy,PAPP-A,and 24-hour total urine protein were independent risk factors for FGR in PE patients(P<0.05).ROC curve analysis revealed that the area under the curve of Hcy and PAPP-A for predicting FGR in PE patients were 0.903 and 0.927,with sensitivities of 0.914 and 0.943 and specificities of 0.877 and 0.864,respectively.Conclusion Serum Hcy levels are elevated and PAPP-A levels are decreased in PE patients complicated with FGR.Both Hcy and PAPP-A can be used to predict the occurrence of FGR in PE patients.