A simultaneous evaluation of second trimester serum AFP, hCG and unconjugated oestriol as predictors of small for gestational age births

M. Di Mario, G. Piazzi, A. Ferrari, M. Lotzniker, O. Gerola, A. Spinillo

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives: To evaluate simultaneously the predictive values of maternal serum alpha-fetoprotein (ms-AFP), human chorionic gonadotrophin (hCG) and unconiugated oestriol(uE3) on the prevalence of fetal growth retardation and small for gestational age (SGA) birth. Method: Midtrimester blood evaluation of ms-AFP, hCG and uE3 was performed in a population of 548 patients who had prenatal care and were delivered at a single institution. Sonographic assessment of fetal growth and evaluation of small for gestational age births was done. Logistic regression analysis with continuous and categorized data was used to evaluate the simultaneous predictive value of midtrimester biochemical markers. Results: In logistic models an abnormal level (≥ 2.5 multiple of median) of ms-AFP was the only independent predictor of SGA (odds ratio = 7.96; 95% confidence interval = 1.04-60.78). When ms-AFP was included in logistic model as a continuous variable, the risk of either SGA or sonographically confirmed intrauterine growth retardation (IUGR) increased by 2.6 and 2.3-fold, respectively, for each multiple of median (MoM) of ms-AFP. Receiver-operator characteristic (ROC) curve study demonstrated that the value of ms-AFP with the simultaneous highest sensibility and specificity in the prediction of SGA, was 1.16 MoM (sensibility = 41.5%, specificity = 80%). An abnormal value of ms-AFP (≥ 2.5 MoM) had a specificity of 99.5% but a sensitivity of 3.5%. Conclusion: Ms-AFP is a better predictor of SGA as compared to both hCG and uE3. Our results suggest that even mild elevations of ms-AFP (> 1 MoM) are a marker of increased risk.

Original languageEnglish
Pages (from-to)155-159
Number of pages5
JournalItalian Journal of Gynaecology and Obstetrics
Volume10
Issue number4
Publication statusPublished - 1998

Fingerprint

Estriol
alpha-Fetoproteins
Second Pregnancy Trimester
Chorionic Gonadotropin
Gestational Age
Mothers
Parturition
Serum
Fetal Growth Retardation
Logistic Models
Prenatal Care
Fetal Development
Biomarkers
Odds Ratio
Regression Analysis
Confidence Intervals

Keywords

  • hCG
  • Maternal serum alpha-fetoprotein
  • Unconjugated oestriol

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

A simultaneous evaluation of second trimester serum AFP, hCG and unconjugated oestriol as predictors of small for gestational age births. / Di Mario, M.; Piazzi, G.; Ferrari, A.; Lotzniker, M.; Gerola, O.; Spinillo, A.

In: Italian Journal of Gynaecology and Obstetrics, Vol. 10, No. 4, 1998, p. 155-159.

Research output: Contribution to journalArticle

@article{1b5d924066d3456482df0ce4aa071d24,
title = "A simultaneous evaluation of second trimester serum AFP, hCG and unconjugated oestriol as predictors of small for gestational age births",
abstract = "Objectives: To evaluate simultaneously the predictive values of maternal serum alpha-fetoprotein (ms-AFP), human chorionic gonadotrophin (hCG) and unconiugated oestriol(uE3) on the prevalence of fetal growth retardation and small for gestational age (SGA) birth. Method: Midtrimester blood evaluation of ms-AFP, hCG and uE3 was performed in a population of 548 patients who had prenatal care and were delivered at a single institution. Sonographic assessment of fetal growth and evaluation of small for gestational age births was done. Logistic regression analysis with continuous and categorized data was used to evaluate the simultaneous predictive value of midtrimester biochemical markers. Results: In logistic models an abnormal level (≥ 2.5 multiple of median) of ms-AFP was the only independent predictor of SGA (odds ratio = 7.96; 95{\%} confidence interval = 1.04-60.78). When ms-AFP was included in logistic model as a continuous variable, the risk of either SGA or sonographically confirmed intrauterine growth retardation (IUGR) increased by 2.6 and 2.3-fold, respectively, for each multiple of median (MoM) of ms-AFP. Receiver-operator characteristic (ROC) curve study demonstrated that the value of ms-AFP with the simultaneous highest sensibility and specificity in the prediction of SGA, was 1.16 MoM (sensibility = 41.5{\%}, specificity = 80{\%}). An abnormal value of ms-AFP (≥ 2.5 MoM) had a specificity of 99.5{\%} but a sensitivity of 3.5{\%}. Conclusion: Ms-AFP is a better predictor of SGA as compared to both hCG and uE3. Our results suggest that even mild elevations of ms-AFP (> 1 MoM) are a marker of increased risk.",
keywords = "hCG, Maternal serum alpha-fetoprotein, Unconjugated oestriol",
author = "{Di Mario}, M. and G. Piazzi and A. Ferrari and M. Lotzniker and O. Gerola and A. Spinillo",
year = "1998",
language = "English",
volume = "10",
pages = "155--159",
journal = "Italian Journal of Gynaecology and Obstetrics",
issn = "1121-8339",
publisher = "CIC Edizioni Internazionali s.r.l.",
number = "4",

}

TY - JOUR

T1 - A simultaneous evaluation of second trimester serum AFP, hCG and unconjugated oestriol as predictors of small for gestational age births

AU - Di Mario, M.

AU - Piazzi, G.

AU - Ferrari, A.

AU - Lotzniker, M.

AU - Gerola, O.

AU - Spinillo, A.

PY - 1998

Y1 - 1998

N2 - Objectives: To evaluate simultaneously the predictive values of maternal serum alpha-fetoprotein (ms-AFP), human chorionic gonadotrophin (hCG) and unconiugated oestriol(uE3) on the prevalence of fetal growth retardation and small for gestational age (SGA) birth. Method: Midtrimester blood evaluation of ms-AFP, hCG and uE3 was performed in a population of 548 patients who had prenatal care and were delivered at a single institution. Sonographic assessment of fetal growth and evaluation of small for gestational age births was done. Logistic regression analysis with continuous and categorized data was used to evaluate the simultaneous predictive value of midtrimester biochemical markers. Results: In logistic models an abnormal level (≥ 2.5 multiple of median) of ms-AFP was the only independent predictor of SGA (odds ratio = 7.96; 95% confidence interval = 1.04-60.78). When ms-AFP was included in logistic model as a continuous variable, the risk of either SGA or sonographically confirmed intrauterine growth retardation (IUGR) increased by 2.6 and 2.3-fold, respectively, for each multiple of median (MoM) of ms-AFP. Receiver-operator characteristic (ROC) curve study demonstrated that the value of ms-AFP with the simultaneous highest sensibility and specificity in the prediction of SGA, was 1.16 MoM (sensibility = 41.5%, specificity = 80%). An abnormal value of ms-AFP (≥ 2.5 MoM) had a specificity of 99.5% but a sensitivity of 3.5%. Conclusion: Ms-AFP is a better predictor of SGA as compared to both hCG and uE3. Our results suggest that even mild elevations of ms-AFP (> 1 MoM) are a marker of increased risk.

AB - Objectives: To evaluate simultaneously the predictive values of maternal serum alpha-fetoprotein (ms-AFP), human chorionic gonadotrophin (hCG) and unconiugated oestriol(uE3) on the prevalence of fetal growth retardation and small for gestational age (SGA) birth. Method: Midtrimester blood evaluation of ms-AFP, hCG and uE3 was performed in a population of 548 patients who had prenatal care and were delivered at a single institution. Sonographic assessment of fetal growth and evaluation of small for gestational age births was done. Logistic regression analysis with continuous and categorized data was used to evaluate the simultaneous predictive value of midtrimester biochemical markers. Results: In logistic models an abnormal level (≥ 2.5 multiple of median) of ms-AFP was the only independent predictor of SGA (odds ratio = 7.96; 95% confidence interval = 1.04-60.78). When ms-AFP was included in logistic model as a continuous variable, the risk of either SGA or sonographically confirmed intrauterine growth retardation (IUGR) increased by 2.6 and 2.3-fold, respectively, for each multiple of median (MoM) of ms-AFP. Receiver-operator characteristic (ROC) curve study demonstrated that the value of ms-AFP with the simultaneous highest sensibility and specificity in the prediction of SGA, was 1.16 MoM (sensibility = 41.5%, specificity = 80%). An abnormal value of ms-AFP (≥ 2.5 MoM) had a specificity of 99.5% but a sensitivity of 3.5%. Conclusion: Ms-AFP is a better predictor of SGA as compared to both hCG and uE3. Our results suggest that even mild elevations of ms-AFP (> 1 MoM) are a marker of increased risk.

KW - hCG

KW - Maternal serum alpha-fetoprotein

KW - Unconjugated oestriol

UR - http://www.scopus.com/inward/record.url?scp=0032430521&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032430521&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:0032430521

VL - 10

SP - 155

EP - 159

JO - Italian Journal of Gynaecology and Obstetrics

JF - Italian Journal of Gynaecology and Obstetrics

SN - 1121-8339

IS - 4

ER -