In singleton pregnancies, the maternal serum biomarkers used in the first-trimester screening for aneuploidies, particularly PAPP-A (pregnancy-associated plasma protein-A), may be used as predictors of adverse perinatal outcomes such as pre-eclampsia (PET), fetal growth restriction (FGR), and preterm birth (PTB) [3–8]. This evidence concerns the gene PAPPA and fetal growth restriction.