The data in this current study show that PAPP-A levels below 0.4 MoM in the first trimester -- as a single maternal serum marker -- are able to identify pregnancies at an increased risk for PE, IUGR, PIH, and occurrence of any adverse pregnancy outcome (PE, PIH, IUGR, fetal and neonatal death) compared to the control population. The gene discussed is PAPPA; the disease is fetal growth restriction.