Associations between pregnancy outcomes and unexplained high and low maternal serum alpha-fetoprotein levels

作者：Puntachai Pongsun; Wanapirak Chanane; Sirichotiyakul Supatra; Tongprasert Fuanglada; Srisupundit Kasemsri; Luewan Suchaya; Traisrisilp Kuntharee; Tongsong Theera^*

来源：Archives of Gynecology and Obstetrics, 2015, 292(1): 81-85.

DOI：10.1007/s00404-014-3606-9

• Fetal death
• Fetal growth restriction
• Low birth weight
• Maternal serum alpha-fetoprotein
• Preterm birth
• Pregnancy-induced hypertension

Objective To determine the relationship between adverse pregnancy outcomes and maternal serum alpha-fetoprotein (MSAFP) levels.
Materials and methods A retrospective cohort study was conducted on consecutive singleton pregnancies, screened for fetal Down syndrome, in the northern part of Thailand. The prospective database of our fetal Down screening program was assessed to recruit all consecutive records. Pregnancies with medical complication and fetal abnormality were excluded. The recruited women were categorized into three groups: normal (>= 0.76 to <= 2.0 MoM), low (<0.76 MoM) and high (>2.0 MoM) MSAFP levels.
Results Of 7,110 screened women, 5,486 met inclusion criteria, including 240; 5,016 and 230 in the group of high, normal and low MSAFP levels, respectively. The rates of preterm birth, pregnancy-induced hypertension (PIH), fetal growth restriction (FGR), fetal death, low birth weight (LBW) and low APGAR scores were significantly higher in women with high MSAFP levels (11.7 vs. 6.6 %, 7.5 vs. 3.3 %, 7.5 vs. 3.3 %, 2.1 vs. 0.3 %, 15.8 vs. 6.7 %, and 2.9 vs. 0.5 % respectively), with relative risk of 1.76, 2.28, 2.27, 7.46, 2.35 and 6.09, respectively. The rates of preterm birth, FGR and LBW were significantly lower in low MSAFP levels with relative risk of 0.39, 0.26 and 0.26, respectively, whereas the rates of PIH and fetal death and low Apgar scores were not significantly different.
Conclusions Pregnant women with high MSAFP levels had an increased risk of poor pregnancy outcomes, while those with low MSAFP levels had a significantly lower risk of such outcomes.

• 出版日期2015-7