Pregnancy-associated plasma protein A (PAPP-A), predominantly produced by placental trophoblastic cells [1] and measured in maternal serum during the first trimester for clinical purposes, has been shown to be a potential predictor of adverse obstetric outcomes [2–6] such as spontaneous miscarriage, small for gestational age (SGA)/intrauterine growth restriction (IUGR), pre-eclampsia, and intrauterine fetal demise (IUFD) [1, 7]. Here, PAPPA is linked to fetal growth restriction.