Elevated midtrimester α-fetoprotein and delivery markers of inflammation in a preterm population.
OBJECTIVE
Determine whether elevated second trimester maternal serum α-fetoprotein (AFP) is associated with clinical and histopathologic markers of inflammation at preterm delivery.


METHODS
105 women <32 weeks' gestation were included. AFP levels were dichotomized at 2.0 multiples of the median (MoM). Rates of neonatal morbidities, clinical chorioamnionitis, cord blood IL-6 level, and placental inflammatory findings were compared.


RESULTS
Thirteen (12.4%) had elevated AFP. Fewer women with AFP ≥ 2 MoM had histologic placental or membrane rupture site inflammation, funisitis, or placental culture positive for Mycoplasma and Ureaplasma species, compared to those with normal AFP. Neonatal death was increased in the elevated AFP group (23.1% vs. 2.27%, RR 10.6). Elevated AFP was associated with a nonsignificant increase in indicated birth (54% vs. 35%; p = 0.225). Virtually all inflammatory findings were confined to the spontaneous delivery group.


CONCLUSIONS
Elevated midtrimester AFP conveyed significant risk of neonatal death, but was negatively associated with clinical or histopathologic inflammation in preterm infants.
Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA. monique_ho@urmc.rochester.edu
Monique
M
Ho
Ona M
OM
Faye-Petersen
Robert L
RL
Goldenberg
Waldemar A
WA
Carlo
Suzanne P
SP
Cliver
William W
WW
Andrews
D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D002821:Chorioamnionitis / Q000097:blood / Q000453:epidemiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology; D007249:Inflammation / Q000097:blood* / Q000453:epidemiology; D009017:Morbidity; D011153:Population; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood* / Q000453:epidemiology; D011262:Pregnancy Trimester, Second / Q000097:blood* / Q000378:metabolism; D047928:Premature Birth / Q000097:blood* / Q000209:etiology / Q000276:immunology; D015854:Up-Regulation; D055815:Young Adult; D000509:alpha-Fetoproteins / Q000032:analysis* / Q000378:metabolism
D015415:Biomarkers; D000509:alpha-Fetoproteins