- Screening maternal serum alpha-fetoprotein (msAFP) abnormalities may predict risk for poor neonatal outcomes, including ischemic placental disease, fetal growth restriction (FGR), and preterm birth.
Why this matters
- msAFP is a fetal glycoprotein synthesized in early pregnancy that diffuses across the placental membrane into the maternal circulation.
- Disruption of this interface leads to altered diffusion and abnormal maternal serum levels.
- msAFP may be used to screen for perinatal risk factors and allow for the initiation of preventive measures.
- Elevated first-trimester msAFP is associated (ORs, 95% CIs) with:
- Ischemic placental disease: 2.26 (1.33-3.87);
- FGR; 3.40 (1.56-7.42); and
- Spontaneous preterm birth: 2.69 (1.26-5.74).
- No association between elevated msAFP and preeclampsia was found.
- Multisite retrospective cohort study.
- Participants with first-trimester msAFP and complete records between 2015 and 2017 were identified (n=1280).
- Elevated msAFP was defined as >2.0 MoM.
- Primary aim was to investigate an association between elevated msAFP at 11-14 weeks of gestation and ischemic placental disease (preeclampsia, FGR, and/or placental abruption).
- Funding: None disclosed.
- Findings did not show an association between preeclampsia and elevated msAFP.
- Incomplete delivery records resulted in smaller study numbers.