open access
Is unexplained elevated maternal serum alpha-fetoprotein still important predictor for adverse pregnancy outcome?
Affiliations- Private Clinic, Duzce, Turkey, Türkiye
- Düzce University, Faculty of Medicine, Duzce, Turkey, Türkiye
open access
Abstract
Objectives: The purpose of this study was to determined the predictive value of maternal serum alpha-fetoprotein (MSAFP) as a marker for adverse pregnancy outcomes.
Material and methods: This study was carried out at Dr. Zekai Tahir Burak Women’s Health Education and Research Hospital between 2009 and 2010. This study included a total of 1,177 pregnant women, including 170 in the study group and 1,007 in the control group. Pregnancy outcomes and characteristics were analyzed with regard to the MSAFP value.
Results: Gestational week, birth weight and APGAR scores were significantly lower in the elevated MSAFP group (p < 0.001). Adverse pregnancy outcomes, such as preterm delivery, preterm premature rupture of membranes (PPROM), oligohydramnios and intrauterine growth restriction (IUGR) rates were increased in the elevated MSAFP group.
Conclusions: Although ultrasound outweighs as a screening method for neural tube defects and non-invasive prenatal testing outweighs for aneuploidy screening MSAFP level in the second trimester is still an important predictor for poor maternal/fetal outcomes.
Abstract
Objectives: The purpose of this study was to determined the predictive value of maternal serum alpha-fetoprotein (MSAFP) as a marker for adverse pregnancy outcomes.
Material and methods: This study was carried out at Dr. Zekai Tahir Burak Women’s Health Education and Research Hospital between 2009 and 2010. This study included a total of 1,177 pregnant women, including 170 in the study group and 1,007 in the control group. Pregnancy outcomes and characteristics were analyzed with regard to the MSAFP value.
Results: Gestational week, birth weight and APGAR scores were significantly lower in the elevated MSAFP group (p < 0.001). Adverse pregnancy outcomes, such as preterm delivery, preterm premature rupture of membranes (PPROM), oligohydramnios and intrauterine growth restriction (IUGR) rates were increased in the elevated MSAFP group.
Conclusions: Although ultrasound outweighs as a screening method for neural tube defects and non-invasive prenatal testing outweighs for aneuploidy screening MSAFP level in the second trimester is still an important predictor for poor maternal/fetal outcomes.
Keywords
alpha-fetoprotein, adverse pregnancy outcome, prenatal tests
About this articleTitle
Is unexplained elevated maternal serum alpha-fetoprotein still important predictor for adverse pregnancy outcome?
Journal
Issue
Article type
Research paper
Pages
325-330
Published online
2017-06-30
Page views
2167
Article views/downloads
13022
DOI
Pubmed
Bibliographic record
Ginekol Pol 2017;88(6):325-330.
Keywords
alpha-fetoprotein
adverse pregnancy outcome
prenatal tests
Authors
Derya Başbuğ
Alper Başbuğ
Cavidan Gülerman
References (20)- Cunningham FG, Lenevo KJ, Bloom SL. Williams Obstetrics. Twenty-Third Edition. McGraw-Hill Companies, New York 2010: 288–289.
- Milunsky A, Canick JA. Maternal serum screening for neural tube and other defects. In: Milunsky A, Canick JA. ed. Genetic disorders and the fetus. Diagnosis, prevention, and treatment, 5th ed. The Johns Hopkins University Press, Baltimore and London 2004: 719.
- Robinson L, Grau P, Crandall BF. Pregnancy outcomes after increasing maternal serum alpha-fetoprotein levels. Obstet Gynecol. 1989; 74(1): 17–20.
- Crandall BF, Robinson L, Grau P. Risks associated with an elevated maternal serum alpha-fetoprotein level. Am J Obstet Gynecol. 1991; 165(3): 581–586.
- Haddow JE, Kloza EM, Smith DE, et al. Data from an alpha-fetoprotein pilot screening program in Maine. Obstet Gynecol. 1983; 62(5): 556–560.
- Milunsky A. Maternal serum screening for neural tube and other defects. In: Milunsky A. ed. Genetic disorders and the fetus. Diagnosis, prevention, and treatment, 3rd ed. The Johns Hopkins University Press, Baltimore 1992: 507–656.
- Wapner RJ, Jenkins TM, Khalek N. Prenatal Diagnosis of Congenital Disorders. In: Creasy RK, Resnik R, Iams JD, Lockwood CJ, Moore T. ed. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice, 6th ed. 2009: 221–226.
- Davidson E, Riley S, Roberts S, et al. Maternal serum activin, inhibin, human chorionic gonadotrophin and alpha-fetoprotein as second trimester predictors of pre-eclampsia. BJOG: An International Journal of Obstetrics and Gynaecology. 2003; 110(1): 46–52.
- Bartkute K, Balsyte D, Wisser J, et al. Pregnancy outcomes regarding maternal serum AFP value in second trimester screening. J Perinat Med. 2016 [Epub ahead of print].
- Tancrède S, Bujold E, Giguère Y, et al. Mid-trimester maternal serum AFP and hCG as markers of preterm and term adverse pregnancy outcomes. J Obstet Gynaecol Can. 2015; 37(2): 111–116.
- Androutsopoulos G, Gkogkos P, Papadopoulos V, et al. Mid-trimester maternal serum AFP levels in predicting adverse pregnancy outcome. Clin Exp Obstet Gynecol. 2009; 36(4): 237–240.
- Wilkins-Haug L. Unexplained elevated maternal serum alpha-fetoprotein: what is the appropriate follow-up? Curr Opin Obstet Gynecol. 1998; 10(6): 469–474.
- Waller DK, Lustig LS, Cunningham GC, et al. The association between maternal serum alpha-fetoprotein and preterm birth, small for gestational age infants, preeclampsia, and placental complications. Obstet Gynecol. 1996; 88(5): 816–822.
- Yuan W, Chen L, Bernal AL. Is elevated maternal serum alpha-fetoprotein in the second trimester of pregnancy associated with increased preterm birth risk? A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2009; 145(1): 57–64.
- Morris RK, Cnossen JS, Langejans M, et al. Serum screening with Down's syndrome markers to predict pre-eclampsia and small for gestational age: systematic review and meta-analysis. BMC Pregnancy Childbirth. 2008; 8: 33.
- Kang JH, Farina A, Park JiH, et al. Down syndrome biochemical markers and screening for preeclampsia at first and second trimester: correlation with the week of onset and the severity. Prenat Diagn. 2008; 28(8): 704–709.
- Wald NJ, Morris JK. Multiple marker second trimester serum screening for pre-eclampsia. J Med Screen. 2001; 8(2): 65–68.
- Katz VL, Chescheir NC, Cefalo RC. Unexplained elevations of maternal serum alpha-fetoprotein. Obstet Gynecol Surv. 1990; 45(11): 719–726.
- Smith GCS, Shah I, Crossley JA, et al. Pregnancy-associated plasma protein A and alpha-fetoprotein and prediction of adverse perinatal outcome. Obstet Gynecol. 2006; 107(1): 161–166.
- Anfuso S, Soncini E, Bonelli P, et al. Second-trimester maternal serum alpha-fetoprotein elevation and its association with adverse maternal/fetal outcome: ten years experience. Acta Biomed. 2007; 78(3): 214–219.
