Elevated levels of midtrimester maternal serum α-fetoprotein are associated with preterm delivery but not with fetal growth retardation

Davis, Richard O.; Goldenberg, Robert L.; Boots, Larry R.; Hoffman, Howard J.; Copper, Rachel L.; Cutter, Gary; DuBard, Mary B.; Cliver, Suzanne P.; Smith, Rima

doi:10.1016/s0002-9378(11)91556-7

Cited by 29 publications

(7 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We began by examining the relation of PTD to maternal serum alpha‐fetoprotein (MSAFP), the most consistent biomarker of PTD among those measured before the third trimester 21 –34 . Our initial investigations confirmed the strong association between unexplained high MSAFP levels and PTD in both African‐American and white women 35 , 36 .…”

Section: Introductionmentioning

confidence: 89%

“…Screening programmes noted that high MSAFP levels also occur in singleton pregnancies in the absence of fetal defects, giving rise to the term ‘unexplained’ elevated MSAFP. In follow‐up studies, the risk of PTD among women with unexplained high MSAFP levels has been 2–10 times that of women with normal MSAFP levels, the range in relative risks dependent in part on the threshold selected for high MSAFP 26 , 32 , 33 , 204 . We hypothesise that excess MSAFP arising from placental and fetal membrane pathology may, under certain conditions, be a marker for either the maternal vascular disease or the infection pathways.…”

Section: Biomarkers Of Multiple Ptd Pathwaysmentioning

confidence: 95%

See 1 more Smart Citation

Pregnancy outcomes and community health: the POUCH study of preterm birth

Holzman¹,

Bullen²,

Fisher

et al. 2001

Paediatric Perinatal Epid

View full text Add to dashboard Cite

In light of the social/ethnic disparity in preterm delivery (PTD) rates, the Pregnancy Outcomes and Community Health (POUCH) Study takes a broad view of the determinants of PTD by attempting to link underlying biological and psychosocial factors. The relationships between placental pathology, maternal biomarkers, and antecedent psychosocial factors are evaluated in three hypothesised pathways of PTD – one characterised primarily by infection, one by maternal vascular disease, and one by premature elevations in corticotropin releasing hormone in the absence of histological evidence of placental pathology. Within each pathway, an emphasis is placed on understanding the roles of stress and of maternal serum alpha‐fetoprotein, an early biomarker associated with PTD. The POUCH Study enrols pregnant women from five Michigan communities. Information about these women and their environments is gathered through detailed interviews and collection of biological samples including hair, urine, saliva, blood, vaginal fluid, and vaginal smear at 15–26 weeks of gestation. We have chosen to focus on the second trimester – a time when pathological processes may have evolved to a detectable stage, but generally before the onset of biological changes that accompany labour. This focus is consistent with the long‐range goal of early detection/intervention and prevention of PTD.

show abstract

Section: Introductionmentioning

confidence: 89%

Section: Biomarkers Of Multiple Ptd Pathwaysmentioning

confidence: 95%

Pregnancy outcomes and community health: the POUCH study of preterm birth

Holzman¹,

Bullen²,

Fisher

et al. 2001

Paediatric Perinatal Epid

View full text Add to dashboard Cite

show abstract

“…Alkaline phosphatase (b) [650,674,675] α-fetoprotein (b) [214][215][216][217][218]220,221,285,293,321,663,[676][677][678] Beta2-macroglobulin (b) [650] Cervical length [263,265,266,268,395,614] Erythroblasts in maternal blood (b) [679] Fetal antigen-1 (b) [637,680] Fetal breathing movements [681] Gravidin / secretory component [682,683] Haematocrit [684] Home uterine activity monitoring [24,685,686] Insulin-like growth factor binding protein-1 (b,c; also nonphosphorylated) [636,687] Major basic protein (b) [688] Nipple stimulation test [689] Placental protein 5 (b) [667] Pregnancy-specific β1 glycoprotein (b) [667] Risk scores [229,232,690,691] * The most accurate or promising markers are printed in bold italic. Abbreviations: a amniotic fluid; b maternal blood; c cervical; s salivary;...…”

Section: Other Tests and Markersmentioning

confidence: 99%

Preterm Birth: A Review

Schellenberg

2006

CWHR

View full text Add to dashboard Cite

Preterm birth at less than 37 weeks gestation is a substantial burden to the community, representing a major source of infant death, severe handicap, and suffering for both victims and their families. Despite considerable research, little progress has been made in its prevention, partly because preterm birth is the endpoint of a silent multifactorial syndrome which begins long before labour starts. Infectious inflammation often plays a central role, but maternal susceptibility is probably also critical. Although progestogen treatment is preventive in some women with a prior history of preterm birth this will have little impact on the overall preterm birth rate unless effective treatment can be used in a much larger population of at risk women. An accurate screening test to identify such women is needed. The discovery of a screening test and of novel treatments requires a better understanding of the underlying biomolecular events. This paper gives an overview of the physiology and molecular biology of normal and abnormal pregnancy and parturition, the causes and consequences of preterm birth, and the difficulties of predicting and preventing preterm birth.

show abstract

“…Moreover, other authors have demonstrated that the maternal serum AFP level is subject to variations according to some maternal factors which should be taken into account at the time of the measurement results. For instance, the maternal serum alpha-fetoprotein level was reported to be significantly higher among black women and significantly lower among diabetic women (Davis et al, 1992;Milunsky et al, 1982).…”

Section: Introductionmentioning

confidence: 99%

Amniotic fluid alpha-fetoprotein is not a useful biological marker of pregnancy outcome

et al. 1999

View full text Add to dashboard Cite

The aim of our study was to determine if the amniotic fluid alpha‐fetoprotein (AFP) level could be a useful predictive biochemical marker of pregnancy outcome. Amniotic fluid AFP measurement was prospectively carried out over a three‐year period. After excluding factors susceptible to modifying AFP measurements, 587 subjects with gestational age between 14 and 20 weeks were selected to compare the amniotic fluid AFP mean levels depending on the occurrence of an adverse outcome. No significant associations between amniotic fluid AFP level and poor pregnancy outcome, i.e. pre‐eclampsia, preterm delivery, premature rupture of fetal membranes, fetal growth retardation and placental abnormalities were observed. The routine measurement of amniotic fluid alpha‐fetoprotein during an amniocentesis procedure was not considered useful in predicting pregnancy complications. Copyright © 1999 John Wiley & Sons, Ltd.

show abstract

Elevated levels of midtrimester maternal serum α-fetoprotein are associated with preterm delivery but not with fetal growth retardation

Cited by 29 publications

References 21 publications

Pregnancy outcomes and community health: the POUCH study of preterm birth

Pregnancy outcomes and community health: the POUCH study of preterm birth

Preterm Birth: A Review

Amniotic fluid alpha-fetoprotein is not a useful biological marker of pregnancy outcome

Contact Info

Product

Resources

About