PAPPA and hypertensive disorder: Several biological factors have been recognized that can impact FF, such as gestational age, weight and/or body mass index (BMI), trisomy, fetal crown-rump length, serum pregnancy-associated plasma protein-A (PAPP-A), serum-free β-human chorionic gonadotropin (β-hCG), hypertension, twins, smoking, and assisted conception, fetal sex, fetal karyotype, and FF is associated with a higher risk of disorders related to the placenta and adverse perinatal outcomes (5).