Wald N, Barker S, Peto R, Brock D J, Bonnar J
Br J Obstet Gynaecol. 1976 Mar;83(3):213-6. doi: 10.1111/j.1471-0528.1976.tb00811.x.
A case-control study involving 63 pregnancies showed that women who had previously had an infant with anencephaly or spina bifida did not have raised serum alpha-fetroprotein (AFP) levels in subsequent unaffected pregnancies. The value of a serum AFP determination in such women is discussed. If the serum AFP level is normal and if ultrasonography excludes anencephaly the risk of spina bifida might be low enough (about 1 per cent) to make diagnostic amniocentesis difficult to justify. Conversely, a high serum AFP value in such women should not be acted on without confirmation of an abnormality by ultrasonography and, if that is negative, by diagnostic amniocentesis.
一项涉及63例妊娠的病例对照研究表明，既往曾生育过无脑儿或脊柱裂患儿的女性，在其后未受影响的妊娠中血清甲胎蛋白（AFP）水平并未升高。文中讨论了对此类女性进行血清AFP测定的价值。如果血清AFP水平正常且超声检查排除无脑儿，脊柱裂的风险可能低至足以（约1%）使诊断性羊膜穿刺术难以得到合理的解释。相反，对此类女性而言，如果血清AFP值高，在未通过超声检查证实异常，以及（若超声检查为阴性）未通过诊断性羊膜穿刺术证实异常之前，不应采取行动。
