Big Hugs! I went through all this during my pregnancy to dd. As my obstetrician explained it, a low PAPP-A is associated of slow growth but this doesn't always happen. I ended up getting an amnio, and in the counseling prior to the procedure the nurse said some women get a low papp-a for no identifiable reason. Everything ended up being fine and dd was delivered a week early (her choice not mine) weighing in at 2.956kg. Its hard not to worry, but a low papp-a sometimes means nothing.