PAPPA and preeclampsia: The associations between PAPP-A levels and preeclampsia or other PRHDs during pregnancy have been diffusely described: the levels of PAPP-A are lower in pregnancies complicated by PRHD compared to the levels in pregnancies with normal blood pressure, as our data confirmed, hence PAPP-A has been proposed as an early marker for the screening of preeclampsia in combination with other serum proteins and maternal demographics30–33.