However, they require a correlation between maternal characteristics and UAD; in the second trimester, however, an even more pronounced decrement in PAPP-A levels has been noted in women who ultimately develop preeclampsia65,66 also found an association of low PAPP-A levels during the first trimester with long-term maternal metabolic outcomes such as the development of de novo diabetes mellitus and increased use of hypoglycaemic agents at 7 and 10-years post pregnancy. Here, PAPPA is linked to urethra adenocarcinoma.