Trying not to freak out about Low PAPP-A 0.26 MoM

[Trying2Bcalmer]

Hi there, I am 17 weeks pregnant and at my 12 week screening it turned out I have low PAPP-A of 0.26 adjusted MoM. I know anything below 0.5 MoM is considered low. After coming back high risk for Downs Syndrome initially, the NIPT (Harmony) test came back as low risk, so Downs is not longer a concern. But everything I read online leads me to have such anxiety. The 16 week check up was all fine. But I'm worrying that by the 20 week scan there will be no heartbeat - as was the case in one story I read on Tommy's that made me cry on behalf of the poor author and for fear of my own situation. She also had low PAPP-A. I haven't felt any movements yet although apparently I have an anterior placenta. I have texted midwife this morning to ask for a quick extra check up before 20 week scan on 17th March so hopefully that will be ok. I know all of this is out of my control. And that I shouldn't worry, but that's almost like saying I shouldn't love this baby - it's impossible. I probably also should not google it but I like to stay informed and realistic generally. I guess if anyone has any advice or reassurance, or suggestions for dealing with this anxiety, i would really appreciate it. I have one son who is 16 months and that was all straight forward. I am 36 so maybe that's a factor. Thanks in advance xx

I had low PAPP A with my last pregnancy and have it again with this one. I was really worried with DS but it caused absolutely no problems. I’ve spoken to a huge amount of medical professionals and the PAPP A testing is still fairly new and I think quite a few of them aren’t really convinced. I spoke to a genetics specialist and she said the stress caused to women by these tests is so great she often wishes they wouldn’t do them.

Same has previous poster. I've had low papp a in all 3 pregnancys. All was fine extra growth scans. Placenta looked heathly afterwards too. All good weights too over 7lbs. Try not to Google to much and enjoy your pregnancy. Speak to the midwives about any of your concerns

Just to add I had horrific anxiety early in this pregnancy because exactly like you found, my age and low PAPP A affected my result for downs. I was absolutely convinced I was going to lose the baby or she would be dreadfully ill. Completely illogically once I found out we were having a boy most of my anxiety went because all the bad things I’d pictured were of a girl. I think it just shows how irrational our anxieties are. That’s not particularly helpful but I just wanted you to k ow you weren’t alone (but I wasn’t concerned about the PAPP A at all) xx

Thanks so much both. I don't suppose either of you have ever suffered from a vitamin B12 deficiency? It's a long shot but I just wondered as it's something I've had issues with, I just wondered if the two things were linked...

@Fueledwithfairydustandgin - that's really reassuring you had no problems but low PAPP-A. How funny you relaxed when you knew it was a boy - maybe because you'd been there before with your first DS too? So glad everything is ok. Give a mother any chance to worry and she will jump at it - I had the same thing with the Downs test - waiting was torture. I think the genetics specialist makes a good point...

@Namechangeforthewin that's amazing you had it with all three pregnancies and so wonderful (not to mention encouraging) that all was ok.

I guess anyone who had a negative outcome with low PAPP-A wouldn't necessarily post on a thread where the OP is asking for reassurance - which as you can see is the punishing nature of my over-working mind - but i nonetheless find your experiences very comforting so thank you.

I’m in the same situation - you best to speak to your Obstetric consultant about how they will manage it - she really put my mind at rest.

It’s not uncommon to have low p-appa.

I do actually have 10 weekly injections for low B12. No one has ever mentioned a potential link though.
I’m currently 35 weeks and all my measurements have been good. DS was overdue and weighed 7.4 so fingers crossed that as suggested by the specialist this is normal levels for my body.

I wrote that completely wrong I have an injection every 10 weeks

@Fueledwithfairydustandgin INTERESTING - I have injections every 3 months minimum too. I found one study linking B12 to first trimester hormone serum markers (including PAPP-A) but more research is needed.

35 weeks and with good measurements - this is just awesome. I hope I can write the same in 18 weeks (yikes that feels like a long time!)

I had low PAPP-A with my now 18 month old. I had 3 or 4 extra scans after the 20 week scan as he could be small. He was born at 37 weeks 5lb15 and is absolutely fine. Both myself and his dad were small babies anyway.

@Trying2Bcalmer I also have low Pappa and was freaked out at first. If you're on facebook there is a group called Low Papp A Pregnancy support group, and honestly it is so overwhelmingly positive (even if someone has complications the outcome is positive 99.99% of the time) it's saved my sanity!

Just on a personal note I'm now over 37 weeks, baby has been 50th percentile most of the pregancy however his growth has dropped slightly so I will be delivering him next week as a precaution. No high blood pressure or other side affects from the low papp-a and the extra care/scans etc have been so reassuring! So whilst I'm delivering a bit earlier than maybe I would have he is still term predicted to be approx 6-6.5lbs which is a positive outcome in my book!

Hope this helps

Thanks everyone, all really helpful, sounds like most babies are small and early but all absolutely fine despite that...

@yzme thanks for the encouraging post and sounds like your little boy was and is just perfect...

@LottieDot thanks too - I’ve joined that FB group and seems v positive. How exciting you’re having your baby next week - wishing you all the best - keep us updated on how it goes (you know with all that free time you’re going to have with a newborn!)

Just to counter my DS has to be induced 11 days over

I had low PAPPA, anterior placenta and came back with high risk for downs (later ruled out by a NIPT test as well) with my little boy.
He was on the 60-75th centile throughout my extra growth scans, at my 20 week he was bang on the 50th. Only slight thing I had was he dropped from the 70 something centile to 50 something again at the 38 week scan I had, they tried to push to induce me as the drop was 1 centile over their acceptable threshold.
I said no as I didn’t feel it was right and he ended up being born naturally at 39+3weeks, 7lb 12oz (around the 50th centile again).
Midwife checked my placenta when it came out and said it all looked perfectly fine.
Try not to worry :) from what I’ve heard PAPPA is just something they like to monitor which normally comes to nothing