Low PAPP-A Level?

Cricket Bug

I have shared this before, but my daughter was born at 28 weeks due to severe IUGR caused by placental insufficiency. As a result, I am being closely monitored as we all wait to see if things will go sideways again this time around.

Today at one such appointment we received our first red flag. Baby boy is still right on target in the 36th percentile at 1lb 1oz, 22w3d, but my MFM doctor is concerned about my PAPP-A level which is incredibly low at 0.16 MoM. The minimum accepted ranges from 0.2-0.4. This is apparently a warning (when considered that the rest of the IPS screen was normal) that my placenta is heading for difficulty. 

Does anyone have any experience with this? I have been reading that it can be linked to a zinc deficiency, but it appears that research is generally inconclusive/lacking. I am terrified of a repeat of my previous experience, and would love to commiserate or hear some stories with happy endings.

Edited because I got my minerals mixed up...

mrsvoorhees-2

I have no experience but I'm sorry you're dealing with this! I hope it's just one random factor that never leads to anything. 

Cricket Bug

@MrsVoorhees Thank you! That's our hope as well!

nativetexan512

No experience but sending support @cricket bug. Keep us updated.

JennM205

@Cricket Bug How often are you going in for checks, with your history? I hope you don't have to wait too long for your next appt / more info. Keep us posted!

ccreagh

My papp-a in this pregnancy was .29. It was never an issue or even brought up in my pregnancy with my son so I had never even heard of a papp-a level before. I was given the talk about risks and everything that comes with it. Our genetic testing ultrasound and the rest of my bloodwork showed no signs of genetic abnormalities so I was told it would be a placenta issue. Because of the papp-a we had a level 2 ultrasound for our anatomy scan and everything looked totally normal. The MFM doctor is having me come in on 7/1 at 30 weeks for a growth ultrasound to make sure we're still on track. 

While I gave no advice for you I do feel for you. It was extremely stressful to receive the news and risks I received. I'm just praying baby continues to grow normally and we have no issues. Only time will tell...

Wishing you the best! 

Cricket Bug

Thank you for all the positivity!! 

@JennM205 I am being followed by both a midwife, and MFM about 2 hours away. My appointments with the MFM dr have been increased to every 3 weeks for uterine dopplers and growth checks. I actually wish that the next appointment was sooner, but comforting to know that the brains behind this is okay with a 3 week delay.

@ccreagh Honestly, one of the things that confuses me most is that the accepted minimum levels seem to range so drastically. The minimum that my dr goes by is 0.2 as set out by the Toronto Placenta Clinic (who knew there was such a thing)! I am so glad that they jumped on it for you and that everything looks great!!  Will you keep me posted after your 30 week scan and let me know how it goes? 

ducks6

I had a borderline low Papp-a result with this pregnancy. My midwife is going to follow up with a couple extra ultrasounds but she said most of the time babies are born perfectly fine after this kind of result. We had a clear genetic screening so if anything, it will be a placenta issue. 

@Cricket Bug can you recommend any resources regarding the link between zinc deficiency and low Papp-a? I am zinc deficient and taking zinc to boost it but now I'm wondering if I should increase the dose. 

Kterhune

I had low PAPP-A scores with my May 2012 kid and again with my Sept16 baby. The first time it developed into pre-eclampsia. This time around I've been put on baby aspirin and calcium and things seem to be going very well. 

ccreagh

@Cricket Bug 
I will definitely keep you posted. Yeah--I don't know why some doctors are ok with some levels and some aren't. My dr. said the lowest he likes to see is .4 (which completely terrified me). I feel like baby is growing ok--I'm feeling her movements everyday. Just hoping her growth doesn't start dropping once I hit third trimester. 

Cricket Bug

@ducks6 it isn't a reliable reference, but I saw this https://www.medicinenet.com/script/main/art.asp?articlekey=24602 and then a bunch of other chat forum conversations with people discussing their naturopaths treating them with zinc and copper supplements (too much zinc can lead to low copper). 

ducks6

@Cricket Bug thanks for the link and information. I'm under the care of a naturopath in addition to my midwives. I seriously believe my naturopath's treatments are the reason this pregnancy has gotten to this stage and will likely result in my rainbow baby. I will discuss this with my naturopath at my next appointment. 

Cricket Bug

@ducks6 I am in the same situation! My naturopath is absolutely wonderful and I owe the success of this pregnancy to her! Let me know what your naturo says!