Low PAPP-A - Would love to hear other experiences!

[lovelsa]

So I had my 12-week blood tests back and they all came back fine - everything was low risk. But the results did highlight that my PAPP-A hormone was low (.38 when they want a minimum of .41; apparently 1.0 is considered the average). I made the mistake of googling PAPP-A before seeing my midwife next week for my 16-week appointment and am a little worried/stressed/anxious.

I'd love to hear from others out there who have experience having low PAPP-A during their pregnancies and what the outcomes were.

The NHS website lists potential complications like low birth weights (due to placental issues), increased likelihood of pre-eclampsia, increased chance of pre-term birth, increased chance of miscarriage in the second half of pregnancy, increased chance of needing to be induced...just a bit much to have come back at you from Google (I know I shouldn't have!!)

Hi. I had low with my first.
They kept a check but didnt have any affect.
That's is really!
Try not to worry too much. It is very common thing but not very often does something happen

I had this for my first pregnancy, and also caused myself lots of worry on google. All my extra growth scans showed a normal size baby. In the end my baby arrived 13 weeks overdue and weighing over 4kg! I wouldn't worry, and its a good thing to have the extra scans. Congratulations on your pregnancy.

13 days overdue! It felt like 13 weeks.

I had low PAPP-A with my second pregnancy. I went into labour at 37 + 1 weeks which may have been linked to the low PAPP-A I don't know. Baby was absolutely fine though. I had a couple of extra scans during the pregnancy to monitor things.

Hi, I’m 37+4 with my second baby.
I had Low Papp-A at the screening at my 12 week scan. I had a telephone appointment with the consultant who explained it can be a pre-cursor for pre-eclampsia or hypertension (i.e. high blood pressure), pre-term birth or low birth weight. This is my second baby and my first did have a low birth weight (5lbs 7oz at 38+4 weeks so not teeny tiny but counted as SGA- small for gestational age). Although I wasn’t diagnosed with Low Papp-A last time, the midwife (at a later appointment) explained that the threshold for what reading counts as low has changed over recent years so it could be that I did have it but didn’t quite reach the threshold.
Because of the Low Papp-A this time I was prescribed to take aspirin daily- 150mg. I got a prescription at first then after then I just bought my own as it’s cheap.
Because one the Low Papp-A combined with my daughter’s low birth weight last time, I’ve been having growth scans and consultant appointments at 28, 32 and 36 weeks (have one booked for 40 weeks too but hoping I don’t make it to that one!!). All has been fine- growth scans show baby is around the 50th centile. I know they’re not 100% accurate. My blood pressure has also been good. Will see what happens over these next couple of weeks before baby’s arrival.

My friend only found out late in pregnancy that she had low Papp-a and had some extra scans. She had quite high BP just before her due date and got very swollen so although not quite pre eclampsia it was enough for them to induce her. Baby was born 9lb 12!!

Oh and she said there is a Facebook support group she found useful.

I’m the same as you - low risk but with lower PAPP-A from 12 week blood test. I’m at 24 weeks now so already had 2nd scan. It was fine and showed a good size. I’ve a growth scan in about a month. It’s good they check on the baby and you get more scans. It’s not uncommon to have low PAPP-A and doesn’t seem to affect most pregnancies. Ironically I was worried the baby would be really big, as both myself and partner were big babies and they moved the due date forward due to size at 12 week scan despite the fact it didn’t line up with dates of conception.

Second pregnancy 34 weeks with low PAPP A but I also had hypertension and suspected preeclampsia and a tiny baby (5lbs3) with my first so the risk factors are stacked. I’m on daily aspirin, a beta blocker for the high bp, and have regular growth scans, but all good so far. At 37 weeks they will decide how early to induce me based on how well she is growing but they won’t let me go past 39 weeks.

I had low Papp-a with my first and I took aspirin every day and had extra scans just incase. Was also induced at 40+5 just incase. Had no complications and she was a healthy weight .

Honestly it was a load of rubbish. I was talked into going to have a CVS where they took placenta and sent off, then they got me into hospital for a scan and a consultant meeting every 4 weeks even though the scans never flagged any issues with estimated growth or weight (in fact the higher risk was probably me getting covid going back and forth) then I went overdue, got induced and had a totally healthy 7lb 13oz baby and the midwifes commented how health the placenta was 🤦‍♀️

Take it with a pinch of salt, some trusts literally wont even give you extra scans for it cos they just arent worried x

I had low PAPP-A in my second pregnancy and they seemed to know very little about it back then. I was given aspirin to take, extra scans for growth and they predicted a smaller baby as my first was 5lb 14oz 18 months earlier. The aspirin was to help the placenta flow. He was born at 39 weeks and was actually 7lb 4oz so bigger than anyone was expecting. I'm now due with baby no 3 7 years later and I'm expecting to have this again. Try not to panic. They gave me an increased Downs Syndrome risk based on the low result but I think that's purely because it's one thing they link to it but now it's more to do with placenta flow x

I had low papp-a in my first pregnancy. Took daily aspirin and was monitored for high bp and low baby size. In the end I had pre-eclampsia, had a failed induction and emcs at 40+6 and my daughter was small with lots of complications. Having said all of that, I had even worse PE in my second pregnancy and my twins were just fine. Most of the stories I’ve heard about low papp-a have good outcomes (just not mine sadly), so fingers crossed everything will be fine.

I had my baby yesterday. I had growth scans and took daily baby aspirin (prescribed by the hospital). Baby is absolutely fine and i had no complications. She was born at 38 weeks weighing 8lb 7! In addition the sonographer, who has been on the job 15 years, said he had never seen a low weight baby due to low papp-a.

It's right to be cautious and follow the guidance, but try not to worry OP. Congrats on your pregnancy x

Hi @lovelsa

I had very low PAPP-A (0.2) with second pregnancy. Told to take aspirin and had 4 weekly growth scans. DD was born a week late at 7 pounds 13. She is now exceptionally tall and bright for her age (6), more so than her sister who did not have low PAPP-A.

Hope that helps :)

Hi! Can’t remember my number but I had low PAPPa
They gave me growth scans from 24 weeks monthly. Son was in at 65-75th centile until my 38 week scan where he dropped to 54th. The drop was 1 centile over what they’re happy with so try tried to push induction as it could be a sign my placenta was degrading. I said no as it was so borderline and instead asked for another scan on my due date, she said if he’d dropped again they’d have to induce (fine by me).
Anyway long story short he arrived naturally at 39 weeks before I even got my scan. Midwife said my placenta was fine and he was born at around the 56th centile so his growth must have just slowed a bit. Perfectly healthy baby!
Don’t worry, it just means they’ll scan you monthly more than likely and may push for induction if growth slows down 😊 most stuff I read the women/babies were fine!

Meant to add baby was 7lb 12oz when born!

Another here with Low PAPP-a, was worried about the risks after Googling but most people I have seen throughout seemed to sort of dismiss it as normally fine. My main concern was having a very small baby but at 35 weeks he was est at 6lb 11 and am going in tomorrow (38 + 3) for another scan to see if baby needs to get moving out with some help due to his size, so kind of the opposite I was worried about!! One sonographer had said to me she had been dealing with ladies With low Papp-a and things for years and years and had only ever seen one baby that seemed to be smaller because of it. So as previously said I just think they are super cautious About everything now, which is great, but can get you worried and asking Dr Google which is not always the best thing to do!!

I am in the same situation. Mine came back as 0.39. I will have extra growth scans, be consultant lead and they've said I won't go past 40 weeks. I'm 17weeks now. I'm not too worried to be honest as it seems rare that things actually go wrong. I'm just taking it as a good thing that they are keeping a closer eye on us. Hopefully we will be fine x

Hi op

I had low papp a with my last pregnancy and had growth scans starting at 28 weeks. My baby was under the 10th centile throughout the scans so I was booked to be induced at 39 weeks. From 37 weeks my blood pressure went up (no sign of pre-eclampsia) so the hospital monitored it on the day unit every other day until 38+2 when they decided to induce there and then. Unfortunately whilst trying to attach a clip to baby's head they found she was breech so had emergency section. She weighed 5lb 12 so very little but absolutely fine. I don't think they know enough about low papp a to say that she was small and my blood pressure was high to say that that was the cause but it seems likely.

A couple of people are saying their sonographer told them they’d never come across ladies with low Papp-A who went on to have low birth weight babies- I’m just wondering, do sonographers get to know the birth weight of babies of ladies that they’ve scanned? I’m not sure how my sonographer would know that my DD’s birth weight was 5lb 7oz?

With my both mine I had low papp-a I had extra growth scans with both, my first I had really high blood pressure towards the end but was not pre-eclampsia, both were just over due date and were considered low birth weights below 5th centile. I had a few issues with my first born and blood sugar levels but think that was due to the drugs I was given for my blood pressure, second no issues and we only had an overnight stay before we went home. I also was advised to take baby aspirin throughout both pregnancies due to the low hormone. Just remember it’s all just risk factors they’re not a diagnosis

I had low papp a in 2 of my pregnancys. Just kept a closer eye on and was induced 4 days before my due date just to make sure everything was still hunky dory. Its quite a new thing they look for. I was put on low aspirin. Baby's weighed 7lb 8oz and 8lb 2oz so good sizes. Don't worry too much as long as baby grows on their line its fine. You'll get extra growth scans so mote chances to see baby.

@LittleRa

A couple of people are saying their sonographer told them they’d never come across ladies with low Papp-A who went on to have low birth weight babies- I’m just wondering, do sonographers get to know the birth weight of babies of ladies that they’ve scanned? I’m not sure how my sonographer would know that my DD’s birth weight was 5lb 7oz?

Good point, one of my sonographer said something similar yet I went on to have a dd weighing 5lb 12

Thank you, everyone! I feel much better; I had no idea this was a thing! I'm seeing my midwife tomorrow, so will obvs talk with her as well, but your experiences have made me feel a bit better and more assured! Thank you again! xx