Low maternal serum level of pregnancy associated plasma protein A (PAPP-A) is known to be associated with the development of pregnancy-related complications like small for gestational age infants, intrauterine fetal demise, gestational diabetes and pre-eclampsia. Assessing the level of PAPP-A at 11-13 weeks of gestation can be helpful to predict pregnancy complications and fetal distress at the time of delivery, as well as chromosomal disorders like Down syndrome. This was a prospective study, conducted for a period of one year in the Department of Obstetrics and Gynaecology. 93 females with singleton pregnancies were divided into 2 groups based on their first trimester PAPP-A MoM values as <0.5MoM or >0.5MoM. A significant association was seen between PAPP-A levels and mother’s BMI. PAPP-A level in maternal serum in first trimester can indicate fetal distress and other pregnancy complications at the time of delivery, but it has a poor positive predictive value. Hence, further studies are required to confirm its significance to predict pregnancy outcome