Unexplained elevated maternal serum alpha-fetoprotein levels and perinatal outcome in an urban clinic population.
OBJECTIVE
Our purpose was to determine whether obstetric patients with unexplained elevated maternal serum alpha-fetoprotein levels from an indigent clinic population are at increased risk for adverse perinatal outcome compared with similar patients with normal values.


METHODS
Perinatal outcomes from inner-city obstetric patients with unexplained elevated maternal serum alpha-fetoprotein levels (> 2.0 multiples of the median) were compared with patients from the same clinic with normal values. The frequency of adverse outcomes in the two groups was subjected to chi 2 analysis.


RESULTS
Adverse perinatal outcomes occurred in 33 of 57 (58%) of the subjects with unexplained elevated maternal serum alpha-fetoprotein levels compared with 163 of 719 (23%) patients with normal values (p < 0.001). Statistically significant differences were observed for abruptio placentae (p < 0.025), intrauterine growth retardation (p < 0.025), stillbirth at > 20 weeks (p < 0.001), and pregnancy-induced hypertension (p < 0.01). Differences in the frequencies of preterm premature rupture of membranes, preterm delivery, pregnancy loss < 20 weeks, and congenital malformations were not statistically significant.


CONCLUSIONS
In contrast to a previous report, we found that unexplained elevated maternal serum alpha-fetoprotein levels confer an increased risk of adverse perinatal outcome in an urban clinic population over and above the already increased risk related to socioeconomic status.
Brazerol
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WF
Department of Obstetrics and Gynecology, Pennsylvania Hospital, Philadelphia 19107.
Grover
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S
Donnenfeld
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AE
D000037:Abruptio Placentae / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D005317:Fetal Growth Retardation / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D011247:Pregnancy / Q000097:blood*; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology; D011256:Pregnancy Outcome; D012307:Risk Factors; D012959:Socioeconomic Factors; D014504:Urban Health; D000509:alpha-Fetoproteins / Q000378:metabolism*
D000509:alpha-Fetoproteins