In addition to this, Spencer’s study [7] reported that the lowest PAPP-A levels were associated with the highest likelihood ratios for these complications. In this context, FASTER (First and Second Trimester Evaluation of Risk) trial findings are particularly noteworthy, as it included data on 34,271 pregnancies from multiple U.S. centers, suggesting that low PAPP-A levels are indicative of increased risk of spontaneous fetal loss, preterm birth, intrauterine growth retardation, gestational hypertension, and preeclampsia [11]. The gene discussed is PAPPA; the disease is fetal growth restriction.