Document Detail


Elevated maternal serum alpha-fetoprotein with low unconjugated estriol and the risk for lethal perinatal outcome.
MedLine Citation:
PMID:  10914624     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether a combination of elevated maternal serum alpha-fetoprotein (MSAFP) and low unconjugated estriol (E3) concentration identifies pregnancies at particularly high risk for fetal abnormality or poor outcome. METHODS: Pregnancy outcomes were reviewed for women with elevated MSAFP (> or =2.0 MoM) from our database of 50,315 women who had received triple marker testing from 1993-1998. Outcomes for those with low E3 (< or =0.7 MoM) were compared with those with normal E3 (>0.7 MoM). The incidences of fetal death, neural tube defects, chromosome abnormalities, congenital abnormalities, preterm birth, small-for-gestational age (SGA), twins, and inaccurate dates were compared in the two groups using Fisher's exact test with P < 0.05 considered significant. RESULTS: Of the 50,315 women screened, 1,435 (2.85%) had an elevated MSAFP. Pregnancy outcomes were obtained in 94% of those with elevated MSAFP and 70% of all patients screened. Neural tube defects were present in 57 fetuses/infants (21 anencephalic, 29 spina bifida, 7 encephalocele) of which 46 (81%) had an elevated MSAFP. Of the 1,435 women with an elevated MSAFP, 199 (14%) had a low E3. Compared to those women with elevated MSAFP but normal E3, women with elevated MSAFP and low E3 were at significantly increased risk for fetal death (20.6% vs. 2.8%, relative risk (RR) 8.9), anencephaly (9.0% vs. 0.1%, RR 122.8) and chromosome abnormality (2.5% vs. 0.6%, RR 4.0). CONCLUSIONS: Pregnancies complicated by elevated second trimester MSAFP and low E3 are at a particularly high risk (32%) for lethal perinatal outcomes. Twins, while a common cause of elevated MSAFP, are rarely found when an elevated MSAFP is associated with low E3.
Authors:
P A Benn; A Craffey; D Horne; L Ramsdell; J F Rodis
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of maternal-fetal medicine     Volume:  9     ISSN:  1057-0802     ISO Abbreviation:  J Matern Fetal Med     Publication Date:    2000 May-Jun
Date Detail:
Created Date:  2000-11-28     Completed Date:  2000-11-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9211288     Medline TA:  J Matern Fetal Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  165-9     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, University of Connecticut Health Center, Farmington 06030-6140, USA. BENN@NSO1.UCHC.EDU
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MeSH Terms
Descriptor/Qualifier:
Biological Markers / blood
Chorionic Gonadotropin / blood
Chromosome Aberrations
Chromosome Disorders
Databases, Factual
Estriol / blood*
Female
Fetal Death
Humans
Predictive Value of Tests
Pregnancy
Pregnancy Outcome*
Retrospective Studies
Risk Factors
alpha-Fetoproteins / analysis*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Chorionic Gonadotropin; 0/alpha-Fetoproteins; 50-27-1/Estriol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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