Author(s)

Rebecca Allen, Shemoon Marleen, Luxmi Velauthar, Kevin Harrington, Joseph Aquilina

Department of Fetal Medicine, Royal London Hospital, London, UK.
Portland Hospital, Great Portland Street, London, UK.

Design: Retrospective analysis. Setting: East London Hospital. Subjects: 724 women who had maternal serum alphafetoprotein levels measured between 15 to 19 weeks gestation. Main outcome measure: The main outcome measures were defined as any case of preeclampsia, small-for-gestational age (SGA) birth- weight < 5^th centile, placental abruption, stillbirth or early neonatal death. Methods: Women with MSAFP > 2.0 Multiples of Median (MoM) were classified as screen positive. Results: 41 (5.7%) women developed preeclampsia. Women with MSAFP > 2.0 Multiples of the Median (MoM) were significantly more likely to develop preeclampsia (p < 0.00001), deliver a SGA < 5^th centile (p < 0.00001), or have a stillbirth/early neonatal death (p < 0.001) compared to women with MSAFP < 2.0 MoM. The odds ratio (OR) for developing preeclampsia was 5.2 (95% confidence interval [CI] 2.4 - 11.3), and 8.2 (CI 2.9 - 23.3) for preeclampsia requiring delivery before 37 weeks gestation. Conclusion: Unexplained elevated MSAFP in the second trimester was strongly associated with a subsequent risk of preeclampsia especially those requiring preterm delivery, as well as other complications related to uteroplacental insufficiency.

AFP; Alpha Fetoprotein; Pre-Eclampsia; Small for Gestational Age; Still Birth; Placental Abruption

Allen, R. , Marleen, S. , Velauthar, L. , Harrington, K. and Aquilina, J. (2013) The relationship between second trimester alpha fetoprotein levels and adverse pregnancy outcome. Open Journal of Obstetrics and Gynecology, 3, 262-266. doi: 10.4236/ojog.2013.32049.