Elevated Second Trimester Alpha-Fetoprotein Increases the Risk of Placenta Accreta
Background: Placenta previa-accreta constitutes an increasing clinical problem, whose diagnosis remains challenging in obstetrics. The current work aimed to assess whether second-trimester serum alpha-fetoprotein (AFP) amounts are altered in pregnant women with placenta previa-accreta versus control...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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IMR Press
2023-11-01
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| Series: | Clinical and Experimental Obstetrics & Gynecology |
| Subjects: | |
| Online Access: | https://www.imrpress.com/journal/CEOG/50/11/10.31083/j.ceog5011232 |
| _version_ | 1797401048155947008 |
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| author | Fengge Wang Dongmei Man Shiguo Liu |
| author_facet | Fengge Wang Dongmei Man Shiguo Liu |
| author_sort | Fengge Wang |
| collection | DOAJ |
| description | Background: Placenta previa-accreta constitutes an increasing clinical problem, whose diagnosis remains challenging in obstetrics. The current work aimed to assess whether second-trimester serum alpha-fetoprotein (AFP) amounts are altered in pregnant women with placenta previa-accreta versus control values. Methods: A retrospective chart review was performed for 504 pregnant women treated between 1 January 2016 and 28 February 2021. This cohort included 105 placenta previa-accreta and 122 placenta previa control cases, as well as 277 body mass index (BMI)-matched individuals with healthy pregnancy. The multiple of the median (MoM) for AFP was obtained from clinical records. Results: Markedly elevated MoM for AFP was detected in the placenta previa-accreta group compared with the placenta previa control and healthy pregnant control groups (both p < 0.001). Serum AFP levels had a significant positive association with placenta accreta after adjustment for age, BMI, and gestational week at blood collection (β = 0.60; 95% confidence interval [95% CI]: 0.52, 0.68; p < 0.001). In addition, previous cesarean delivery history (β = 3.41; 95% CI: 2.18, 5.34; p < 0.001) also had a significant association with placenta accreta. Conclusions: Elevated second-trimester serum AFP had a positive association with placenta accreta. Such finding suggests a potential role for AFP in detecting pregnancies at high-risk of placenta accreta. This second-trimester biomarker of AFP may help classify women into the high- and low-risk groups for placenta accreta. In addition, we have validated a previous history of cesarean section as a risk factor for accreta in patients with placenta previa. |
| first_indexed | 2024-03-09T02:03:16Z |
| format | Article |
| id | doaj.art-e6900322513948dcad7c6e81fa74b9b1 |
| institution | Directory Open Access Journal |
| issn | 0390-6663 |
| language | English |
| last_indexed | 2024-03-09T02:03:16Z |
| publishDate | 2023-11-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Clinical and Experimental Obstetrics & Gynecology |
| spelling | doaj.art-e6900322513948dcad7c6e81fa74b9b12023-12-08T02:49:16ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632023-11-01501123210.31083/j.ceog5011232S0390-6663(23)02177-2Elevated Second Trimester Alpha-Fetoprotein Increases the Risk of Placenta AccretaFengge Wang0Dongmei Man1Shiguo Liu2The Prenatal Diagnosis Center, The Affiliated Hospital of Qingdao University, Qingdao University, 266003 Qingdao, Shandong, ChinaThe Prenatal Diagnosis Center, The Affiliated Hospital of Qingdao University, Qingdao University, 266003 Qingdao, Shandong, ChinaThe Prenatal Diagnosis Center, The Affiliated Hospital of Qingdao University, Qingdao University, 266003 Qingdao, Shandong, ChinaBackground: Placenta previa-accreta constitutes an increasing clinical problem, whose diagnosis remains challenging in obstetrics. The current work aimed to assess whether second-trimester serum alpha-fetoprotein (AFP) amounts are altered in pregnant women with placenta previa-accreta versus control values. Methods: A retrospective chart review was performed for 504 pregnant women treated between 1 January 2016 and 28 February 2021. This cohort included 105 placenta previa-accreta and 122 placenta previa control cases, as well as 277 body mass index (BMI)-matched individuals with healthy pregnancy. The multiple of the median (MoM) for AFP was obtained from clinical records. Results: Markedly elevated MoM for AFP was detected in the placenta previa-accreta group compared with the placenta previa control and healthy pregnant control groups (both p < 0.001). Serum AFP levels had a significant positive association with placenta accreta after adjustment for age, BMI, and gestational week at blood collection (β = 0.60; 95% confidence interval [95% CI]: 0.52, 0.68; p < 0.001). In addition, previous cesarean delivery history (β = 3.41; 95% CI: 2.18, 5.34; p < 0.001) also had a significant association with placenta accreta. Conclusions: Elevated second-trimester serum AFP had a positive association with placenta accreta. Such finding suggests a potential role for AFP in detecting pregnancies at high-risk of placenta accreta. This second-trimester biomarker of AFP may help classify women into the high- and low-risk groups for placenta accreta. In addition, we have validated a previous history of cesarean section as a risk factor for accreta in patients with placenta previa.https://www.imrpress.com/journal/CEOG/50/11/10.31083/j.ceog5011232alpha-fetoprotein afpplacenta accretasecond trimester serumassociation |
| spellingShingle | Fengge Wang Dongmei Man Shiguo Liu Elevated Second Trimester Alpha-Fetoprotein Increases the Risk of Placenta Accreta Clinical and Experimental Obstetrics & Gynecology alpha-fetoprotein afp placenta accreta second trimester serum association |
| title | Elevated Second Trimester Alpha-Fetoprotein Increases the Risk of Placenta Accreta |
| title_full | Elevated Second Trimester Alpha-Fetoprotein Increases the Risk of Placenta Accreta |
| title_fullStr | Elevated Second Trimester Alpha-Fetoprotein Increases the Risk of Placenta Accreta |
| title_full_unstemmed | Elevated Second Trimester Alpha-Fetoprotein Increases the Risk of Placenta Accreta |
| title_short | Elevated Second Trimester Alpha-Fetoprotein Increases the Risk of Placenta Accreta |
| title_sort | elevated second trimester alpha fetoprotein increases the risk of placenta accreta |
| topic | alpha-fetoprotein afp placenta accreta second trimester serum association |
| url | https://www.imrpress.com/journal/CEOG/50/11/10.31083/j.ceog5011232 |
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