Unexplained elevated maternal serum alpha-fetoprotein is not predictive of adverse perinatal outcome in an indigent urban population.
OBJECTIVE
The null hypothesis of this study is that in an urban, indigent obstetric population at high risk for adverse perinatal outcome, unexplained elevations of maternal serum alpha-fetoprotein are not an additional predictor of adverse perinatal outcome.


METHODS
Perinatal outcomes of 72 patients from a clinic for indigent patients with unexplained elevated maternal serum alpha-fetoprotein levels were compared with those of matched controls from the same population with normal maternal serum alpha-fetoprotein levels. Subjects and controls were matched for age, race, parity, and presence or absence of Hollister risk factors. The frequency of adverse perinatal outcome in the two groups was subjected to matched-pair chi 2 analysis.


RESULTS
Adverse perinatal outcome occurred in 38.9% (28 of 72) of subjects with unexplained elevated maternal serum alpha-fetoprotein levels greater than or equal to 2.5 multiples of the median, compared with 31.9% (23 of 72) of controls with normal maternal serum alpha-fetoprotein levels (p = 0.5). No statistically significant difference in adverse perinatal outcomes was found.


CONCLUSIONS
Elevated maternal serum alpha-fetoprotein levels offer little if any additional predictive value for adverse perinatal outcome in populations already at high risk for such outcomes on the basis of obstetric or socioeconomic criteria.
Department of Obstetrics and Gynecology, University of Tennessee, Memphis 38163.
O P
OP
Phillips
J L
JL
Simpson
C D
CD
Morgan
R N
RN
Andersen
L P
LP
Shulman
C M
CM
Meyers
B
B
Sibai
D C
DC
Shaver
E A
EA
Tolley
S
S
Elias
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D005260:Female; D006801:Humans; D011203:Poverty; D011237:Predictive Value of Tests; D011247:Pregnancy / Q000097:blood*; D011256:Pregnancy Outcome; D012307:Risk Factors; D014505:Urban Population; D044465:White People; D000509:alpha-Fetoproteins / Q000032:analysis*
D000509:alpha-Fetoproteins