Maternal and fetal serum transformed alpha-fetoprotein levels in normal pregnancy (original) (raw)
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Alpha fetoprotein: Physiology and pathology during pregnancy and application to antenatal diagnosis
Journal of Perinatal Medicine, 1973
Alpha fetoprotein (AFP) is synthesized by the x human fetal liver and yolk sac [8, 9]. During the 12 th-14 th intrauterine weeks the serum concentration of AFP is at its highest, reaching a few milligrams per ml [7]. However, the total amount of AFP in the fetus increases until the 22 nd week of gestation, remaining constant until about the 32 nd week, and thereafter decreasing [7]. In the newborn at term, the serum AFP concentration is 50-ISO^g per ml [19]. AFP remains detectable by immunodiffusion or related methods for about 5 weeks after birth [24]. Greatly increased serum AFP levels cften reappear in adults with primary hepatocellular cancer [25] or teratocarcinomas [1]. Until recently, the occurrence of AFP in maternal serum had been contested [3]. We purified immunochemically human AFP [14] and developed a radioimmunoassay (RIA) for its determination [15]. It became evident thät small amounts (2-16 ng per ml) of AFP are present in normal human serum [15, 16]. This finding has now been confirmed by other groups [6, 13]. AFP levels in maternal serum increase during pregnancy and the highest AFP concentrations occur during the third trimester. The half life of maternal serum AFP after delivery is about 5 days [19]. In amniotic fluid, the AFP concentrations decrease from the 15 th week of gestation, and at term the concentrations are similar to those in maternal serum [19, 21]. Recently, we found that the maternal serum AFP concentration often increases in asso-Curriculum vitae
Study on Elevated Maternal Serum Alpha-Fetoprotein in Second Trimester and Pregnancy Outcome
2015
This study was a prospective observational study sponsored by DBT (Department of Biotechnology), New Delhi. It was carried out in Gauhati Medical College and Hospital during the period 2014-15 with a total of 202 women whose maternal serum alpha-fetoprotein (MSAFP) was measured between 16 and 20 weeks of gestation. The objective of the study was to determine whether elevated MSAFP level between 16 and 20 weeks of gestation is associated with increased risk of adverse pregnancy outcome including preterm birth, preeclampsia/ eclampsia, SGA, Stillbirth/Neonatal death. MSAFP level was determined by using an immunometric immunoassay technique. Women with MSAFP level ≥ 2.5MoM were defined as elevated MSAFP. Results showed women with elevated MSAFP were significantly more likely to have subsequent adverse pregnancy outcome (70%) compared to women with MSAFP < 2.5 MoM (18.6%) (p<0.0001) with a relative risk of 3.76 (95% confidence interval 2.5 -5.5).It was thus concluded from the stud...
The value of early third-trimester maternal serum alpha-fetoprotein determination
Prenatal Diagnosis, 1990
The value of determination of maternal serum of alpha-fetoprotein (MSAFP) concentration in i he second trimester is well established. In addition to open neural tube defects, pregnancies associated with elevated second-trimester MSAFP have been shown to be at increased risk for a variety of problems, including low birth weight, preterm delivery, and pregnancy-induced hypertension (PIH). We evaluated the potential usefulness of MSAFP in the early third trimester. MSAFP concentration was determined in over 200 women at the time of glucose screening. Results were analysed with regard to gestational age at sampling, maternal weight, race, diabetes, and presence of twins. MSAFP was twice as high in twin gestation, but not affected by race or the presence of diabetes. In contrast to levels in early gestation, third-trimester MSAFP does not appear to be predictive of preterm delivery, low birth weight, or PIH.
The role of maternal serum alpha-fetoprotein in preterm birth: A literature review
World Journal of Advanced Research and Reviews
Preterm birth is one of the most important global issues. Mortality and morbidity among children under 5 years, including neonates, is affected by preterm birth. A good maternal care, health workers, and health facilities play an important role in the outcome of pregnancy, including preterm birth. An early screening test for pregnancy is crucial to find any abnormality thus preterm birth can be predicted and the following treatment may be applied without delay. One of potential biomarker for the screening test is alpha-fetoprotein (AFP) that can be found in maternal serum. Web-based literature search was carried out using several keywords. This literature review aims to collect data and articles to conclude the correlation of the potential biomarkers in diagnostic of preterm birth.
Second-trimester maternal serum alpha-fetoprotein and risk of adverse pregnancy outcome
Obstetrics & Gynecology, 2001
Background: It is well known that second-trimester maternal serum alpha-fetoprotein (MS-AFP) is a predictor for adverse pregnancy outcomes (APOs), such as preterm birth, stillbirth, preeclampsia and small for gestational age (SGA). However, it is unknown whether rst-trimester MS-AFP is also predictive of APOs. Methods: We retrospectively reviewed the data on the rst-trimester MS-AFP levels and pregnancy outcomes of 3325 singleton pregnant women. The cutoff value of 2.5 multiple of the median (MoM) was used to evaluate the risks of APOs regarding MS-AFP. The receiver operating characteristic (ROC) curves were used to evaluate the predictive e ciencies of MS-AFP to these disorders. Results: A total of 181 pregnancies resulted in preterm birth, 32 in stillbirth, 81 in preeclampsia, and 362 in SGA. Compared to women with MS-AFP < 2.5MoM, those with MS-AFP ≥ 2.5MoM had increased risks (odds ratio, 95% con dence interval) of preterm birth (2.53, 1.65~3.88), preeclampsia (3.05, 1.71~5.43) and SGA (1.90, 1.34~2.69), and had an earlier distribution of gestational weeks at delivery (P = 0.004) and a lower distribution of neonatal birth weights (P = 0.000), but the actual between-group differences were minuscule. The areas under ROC curves were 0.572 (P = 0.001), 0.579 (P = 0.015) and 0.565 (P = 0.000) for preterm birth, preeclampsia and SGA, respectively. Subdivisions for the disorders did not obviously improve the performances of MS-AFP. Conclusions: Elevated rst-trimester MS-AFP is associated with increased risk of preterm birth, preeclampsia and SGA. However, the predictive e ciencies were low and it is not a good predictor for these APOs.
First trimester maternal serum alpha-fetoprotein in fetal trisomies
BJOG: An International Journal of Obstetrics and Gynaecology, 1995
Purpose: To investigate the predictive values of first-trimester maternal serum alpha-fetoprotein (MS-AFP) to preterm birth, stillbirth, preeclampsia and small for gestational age (SGA). Methods: We retrospectively reviewed the data on the first-trimester MS-AFP levels and pregnancy outcomes of 3325 singleton pregnant women. The cutoff value of 2.5 multiple of the median (MoM) was used to evaluate the risks of adverse pregnancy outcomes (APOs) regarding MS-AFP. The receiver operating characteristic (ROC) curves were used to evaluate the predictive efficiencies of MS-AFP to these disorders. Results: A total of 181 pregnancies resulted in preterm birth, 32 in stillbirth, 81 in preeclampsia, and 362 in SGA. Compared to women with MS-AFP < 2.5MoM, those with MS-AFP ≥ 2.5MoM had increased risks (odds ratio, 95% confidence interval) of preterm birth (2.53, 1.65~3.88), preeclampsia (3.05, 1.71~5.43) and SGA (1.90, 1.34~2.69), while the risk of stillbirth was not significantly increased (1.33, 0.40~4.41). The areas under ROC curves were 0.572 (P = 0.001), 0.597 (P = 0.060), 0.579 (P = 0.015) and 0.565 (P = 0.000) for preterm birth, stillbirth, preeclampsia and SGA, respectively. Women with MS-AFP ≥ 2.5MoM had an earlier distribution of gestational weeks at delivery (P = 0.004) and a lower distribution of neonatal birth weights (P = 0.000) compared to those with MS-AFP < 2.5MoM, but the actual between-group differences were minuscule. Conclusion: Elevated first-trimester MS-AFP is associated with increased risk of preterm birth, preeclampsia and SGA. However, the predictive efficiencies were low and it is not a good predictor for these APOs.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018
Background: Alpha-fetoprotein (AFP) is the major serum protein in the embryonic stage and in the early fetal stage. The aim of this study was to measure maternal serum AFP levels in second trimester between 15-20 weeks of gestation and to determine whether unexplained elevated MSAFP levels is an effective predictor of adverse pregnancy outcome among Indian population. Methods: This study was a prospective observational study, carried out on 400 pregnant women. Maternal serum alpha-fetoprotein (MSAFP) was measured between 15 and 20 weeks of gestation after excluding congenital malformation or birth defects. MSAFP level was determined by using a radio-immunoassay technique. Women with MSAFP level >2.0 MoM was considered as abnormal while MSAFP level≤ 2.0 MoM was considered as normal. All women were followed up till delivery and pregnancy outcomes were noted and compared between two groups. Results: Women with elevated MSAFP had significantly higher adverse pregnancy outcomes (75.4%) compared to women with MSAFP ≤2.0 MoM (26.1%) (p<0.0001 with relative risk of 2.89, 95% confidence interval 2.276-3.667). Conclusions: Unexplained elevated MSAFP has high sensitivity, specificity, positive predictive value and negative predictive value in predicting adverse pregnancy outcomes. It would, therefore be worthwhile screening pregnant women in second trimester for maternal serum alpha-fetoprotein levels as it would help to identify high risk pregnancies and allow close antenatal survillence for better pregnancy outcome.
Mid-trimester maternal serum AFP levels in predicting adverse pregnancy outcome
Clin Exp Obstet Gynecol, 2008
Objective: In this prospective study, we investigated the association between mid-trimester maternal serum alpha-fetoprotein AFP (MSAFP) levels and adverse pregnancy outcome in a South-Western Greek population. Materials and methods: 110 healthy Greek women with spontaneous pregnancies, investigated for MSAFP levels between the 13th and 24th week of gestation and followed for adverse pregnancy outcome. AFP levels > 2.0 multiples of the median value for gestation were considered abnormal. Statistical analysis was performed by Pearson's chi-square test. Results: Elevated MSAFP levels were detected in a total of 27 of the 110 women studied (24.5%). Among them, only four women (14.8%) developed pregnancy complications. Conclusion: Multiparameter testing of placental function in the mid-trimester (uterine artery Doppler, placental morphology and MSAFP screening) may allow us to identify women with increased risk of developing severe placental insufficiency and pregnancy complications.
Maternal plasma alpha-fetoprotein and low birthweight: a prospective study throughout pregnancy
BJOG: An International Journal of Obstetrics and Gynaecology, 1982
Maternal plasma a-fetoprotein (AFP) was measured serially between 15 weeks gestation and term in 520 patients. Thirty-seven of these women were delivered of normal singleton infants with birthweights (2. 5 kg. The median plasma AFP values in this group of women were highest between 15 and 20 weeks gestation and then declined steadily towards term. It is concluded that the use of maternal plasma or serum AFP in the early detection of low birthweight babies is optimal in the period most suitable for screening for fetal neural tube defects.