PAPPA and fetal growth restriction: Specifically, the literature shows that low PAPP-A and PlGF levels, low alkaline phosphatase, higher sFlt-1 levels, higher AFP levels, and elevated levels of inflammatory markers such as β-hGC, interferon-gamma (INF-γ), and tumor necrosis factor-α (TNF-α) may be associated with the risks of adverse perinatal outcomes, including the onset of pregnancy-induced hypertensive disorders, fetal growth restriction, and delivery of SGA neonates.