PAPPA and fetal growth restriction: On the other hand, severe IUGR under 5th percentile (n = 44, 9.8%) were significantly associated with a low fetal fraction in cfDNA assay (OR = 0.87, ICI 95% 0.79–0.96, p = 0.006), in addition to gestational age at cfDNA assay (OR = 1.12, CI 95% 1.02–1.25, p = 0.019), PAPP-A level (OR 0.31, CI 95% 0.17–0.59, p = 0.0003) and medically assisted procreation (OR = 3.75, CI 95% 1.18–11.90, p = 0.025).