The pattern of change of PAPP-A was established in three separate groups of patients. Day-to-day change from the 38th week was measured in six healthy patients whose pregnancies ended in spontaneous labour. The slow fluctuations of PAPP-A suggest that values found in labour are a consequence of events prior to the onset of labour. Increases of PAPP-A during the last few days of pregnancy and into labour were compared in patients going into labour spontaneously and patients who were induced. The induced patients showed a sharper increase in PAPP-A during this interval than the spontaneous onset group. A comparison at an earlier stage of pregnancy of PAPP-A increase was made between normal pregnancies going into labour on or before 280 days and those who went into labour later. Between 31 +/- 1 and 35 +/- 1 weeks, those who delivered in the earlier group showed a sharper rise in PAPP-A. It seems likely that the behaviour of PAPP-A in late pregnancy is the consequence of uterine activity and it seems unlikely that an increasing level of PAPP-A in itself has anything to do with the initiation of spontaneous labour.
Death rates were initially higher in the areas where masks became required, the analysis found. In the weeks after mask requirements were put in place, areas where masks were required showed sharper declines in deaths per 100,000 population compared to areas where masks were never required.
df19127ead