Relationship Between the Second Trimester Maternal Serum AFP of Aneuploidy in Pregnancies and Placenta Accreta: A Cohort Study

Abstract

Objectives At present, placenta previa-accreta is a growing concern and is still a diagnostic challenge for obstetricians. This study aimed to investigated whether second trimester serum Alpha-fetoprotein (AFP) differed among pregnancies with placenta previa-accreta and placenta previa controls and healthy pregnant controls. Methods A retrospective chart review was performed. In 1 January 2016–30 February 2021, a total of 504 pregnant women were identified and included in our analysis as follows: 105 cases of placenta previa-accreta, 122 cases of placenta previa controls, and 277 cases of BMI-matched, healthy pregnant controls. AFP multiples of the median (MoM) were acquired from laboratory data files. Results AFP MoM of placenta previa-accreta group was significantly higher than those of the placenta previa controls and healthy pregnant controls group (p < 0.001, p < 0.001). Serum AFP was significantly positively associated with placenta accreta after adjusted age, BMI, and gestational week at time of blood sampling (β: 0.60; 95% CI: 0.52–0.68; p < 0.001). In addition, previous cesarean section history (β: 3.41; 95% CI: 2.18–5.34; p < 0.001) was also significantly associated with placenta accreta. Conclusion Increased second trimester serum AFP was significantly positively associated with placenta accreta. Such finding suggests the potential role of AFP in identifying pregnancies that are at high risk for placenta accreta. Second trimester biomarker of AFP can be used to raise a suspicion toward characterizing women into high-risk and low-risk groups for placenta accreta. In addition, previous cesarean section history may be a risk factor for accreta in placenta previa patients.