Serum PAPP‐A levels are depressed in women with fetal Down syndrome in early pregnancy

Abstract
The value of maternal serum pregnancy‐associated plasma protein (PAPP)‐A in screening for Down syndrome in early pregnancy was assessed using stored samples. Seventeen cases of Down syndrome and 66 unaffected control pregnancies were studied. The median PAPP‐A level in the cases was 0.42 multiples of the expected value in controls (p <0.0001). Eleven cases (65 per cent) had levels less than half the expected value compared with only six controls (9 per cent). A commercial assay kit is now needed so that prospective screening with this marker can begin.