Capeless E L, Kelleher P C, Walters C P
Department of Obstetrics and Gynecology, University of Vermont College of Medicine, Medical Center Hospital of Vermont, Burlington 05401.
J Reprod Med. 1992 Mar;37(3):257-60.
Maternal serum alpha-fetoprotein (MS-AFP) screening programs identify a population of pregnant women with elevated MS-AFP values. When the levels are unassociated with a fetal anomaly, those women have a high incidence of pregnancy complications. Such patients were compared to a population with normal MS-AFP values to determine the incidence of historical risk factors and to ascertain if their presence affected the rate of pregnancy complications. A total of 358 patients were followed prospectively, 23 with elevated MS-AFP levels and 335 with normal levels (control group). Historical risk factors were more frequent in the patients with elevated MS-AFP levels. There was a fourfold increase in the rate of pregnancy complications when a patient had both risk factors and elevated MS-AFP levels as compared with elevated MS-AFP levels alone. In the control group, patients with known risk factors experienced twice the incidence of pregnancy complications as did patients with no risk factors. Using multiple logistic regression analysis, elevated MS-AFP levels were shown to be an independent variable in the risk assessment. The results of this study have wide application in the counseling and follow-up of patients identified by MS-AFP screening programs.
母血清甲胎蛋白（MS-AFP）筛查项目可识别出母血清甲胎蛋白值升高的孕妇群体。当这些水平与胎儿异常无关时，这些女性发生妊娠并发症的几率较高。将这些患者与母血清甲胎蛋白值正常的人群进行比较，以确定既往风险因素的发生率，并确定这些因素的存在是否会影响妊娠并发症的发生率。总共对358例患者进行了前瞻性随访，其中23例母血清甲胎蛋白水平升高，335例水平正常（对照组）。既往风险因素在母血清甲胎蛋白水平升高的患者中更为常见。与仅母血清甲胎蛋白水平升高相比，当患者同时存在风险因素和母血清甲胎蛋白水平升高时，妊娠并发症的发生率增加了四倍。在对照组中，已知有风险因素的患者发生妊娠并发症的几率是无风险因素患者的两倍。使用多元逻辑回归分析，母血清甲胎蛋白水平升高被证明是风险评估中的一个独立变量。本研究结果在MS-AFP筛查项目所识别患者的咨询和随访中具有广泛应用。
