Introduction: To evaluate the predictive value of first-trimester nuchal translucency (NT) and pregnancy-associated plasma protein-A (PAPP-A) MoM levels for pregnancy complications and perinatal outcomes, and to assess their clinical utility in a district hospital lacking tertiary neonatal intensive care facilities. Methods: This retrospective cohort study included 422 singleton pregnancies that underwent first-trimester combined testing at Simav State Hospital between May 2021 and September 2025. Multiple pregnancies, fetal anomalies, major maternal diseases, and incomplete data were excluded. NT, PAPP-A, and free β-hCG values were expressed as multiples of the median (MoM). Outcomes included birthweight, neonatal intensive care unit (NICU) admission, and tertiary referral. ROC curve analysis, Youden index, and multivariate logistic regression were performed. Results: Mean NT, PAPP-A, and β-hCG MoM values were 1.05 ± 0.27, 0.88 ± 0.31, and 1.17 ± 0.42, respectively. NICU admission was significantly higher in pregnancies with NT >1.5 MoM (26.4% vs 9.2%; p < 0.01). Low PAPP-A (<0.5 MoM) was associated with tertiary referral (OR=2.91; 95% CI:1.12–7.54; p=0.028). β-hCG levels showed no significant association. Conclusion: First-trimester NT and PAPP-A MoM levels may help predict non-chromosomal adverse pregnancy outcomes. Combined assessment of these parameters could facilitate early identification of high-risk pregnancies in low-resource settings.
Kocar et al. (Tue,) studied this question.