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

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

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.

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Abbreviations

MSAFP:

Maternal serum alpha-fetoprotein

PIH:

Pregnancy-induced hypertension

FGR:

Fetal growth restriction

LBW:

Low birth weight

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Acknowledgments

The Faculty of Medicine Research Fund of Chiang Mai University, and the National Research University Project under Thailand’s Office of the Higher Education Commission.

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand

    Pongsun Puntachai, Chanane Wanapirak, Supatra Sirichotiyakul, Fuanglada Tongprasert, Kasemsri Srisupundit, Suchaya Luewan, Kuntharee Traisrisilp & Theera Tongsong

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  1. Pongsun Puntachai
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  2. Chanane Wanapirak
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  3. Supatra Sirichotiyakul
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  4. Fuanglada Tongprasert
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  5. Kasemsri Srisupundit
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  6. Suchaya Luewan
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  7. Kuntharee Traisrisilp
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  8. Theera Tongsong
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Corresponding author

Correspondence to Theera Tongsong.

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Puntachai, P., Wanapirak, C., Sirichotiyakul, S. et al. Associations between pregnancy outcomes and unexplained high and low maternal serum alpha-fetoprotein levels. Arch Gynecol Obstet 292, 81–85 (2015). https://doi.org/10.1007/s00404-014-3606-9

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  • DOI: https://doi.org/10.1007/s00404-014-3606-9

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