The effects on fetal development of high alpha-fetoprotein and maternal smoking.
OBJECTIVE
This study determined the risk of impaired fetal growth resulting from the interaction between maternal smoking during pregnancy and unexplained elevated concentrations of maternal serum alpha-fetoprotein (MSAFP).


METHODS
This observational study involved 123 pregnant smokers with unexplained second-trimester elevated concentrations of MSAFP, 827 smokers with normal levels, and 471 nonsmokers with raised levels.


RESULTS
By logistic regression, coincident smoking and elevated MSAFP levels were found to be associated with increases in the low basic risks of prematurity, small-for-gestational-age births, low birthweight, and need for neonatal care.


CONCLUSIONS
Maternal smoking has an adverse effect on fetal development in pregnancies with unexplained elevated MSAFP concentrations. Such pregnancies merit close surveillance.
Heinonen
S
S
Department of Obstetrics and Gynecology, Kuopio University Hospital, Finland. seppo.heinonen@kuh.fi
Ryynänen
M
M
Kirkinen
P
P
D000328:Adult; D016022:Case-Control Studies; D005314:Embryonic and Fetal Development; D005260:Female; D005317:Fetal Growth Retardation / Q000209:etiology*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D016015:Logistic Models; D007752:Obstetric Labor, Premature / Q000209:etiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood*; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D012907:Smoking / Q000009:adverse effects* / Q000097:blood*; D000509:alpha-Fetoproteins / Q000032:analysis / Q000378:metabolism*
D000509:alpha-Fetoproteins