Pregnancy outcomes regarding maternal serum AFP value in second trimester screening.

AIM: The aim of this study was to evaluate the predictive value of α-fetoprotein in maternal serum (MS-AFP) as a marker for diverse pregnancy outcomes. METHODS: The study was based on pregnancy and delivery data from 5520 women between 1999 and 2014 at University Hospital of Zurich (UHZ). INCLUSION CRITERIA: both MS-AFP and pregnancy outcome were known for the same pregnancy. Pregnancy outcomes and characteristics such as fetal malformation, intrauterine fetal death (IUFD) and intrauterine growth retardation as well as maternal age, weight before pregnancy, gestational age (GA) at delivery, newborn weight, length and head circumference were analyzed with respect to the MS-AFP value. MS-AFP value was categorized into three groups: elevated MS-AFP>2.5 multiples of the median (MoM), normal 0.5-2.49 MoM and decreased <0.5 MoM. RESULTS: Newborn weight (g) and length (cm) were significantly lower in the elevated MS-AFP (P<0.001) group, and infants had 1 week lower GA at delivery (P<0.05). In the group of elevated MS-AFP (n=46), 26.1% of pregnancies were significantly related to adverse pregnancy outcomes, such as fetal malformations, fetuses small for gestational age (SGA) and IUFD. Adverse pregnancy outcomes of 5.6% were registered in the group of normal MS-AFP and 7.3% in the group of low MS-AFP (P<0.05). CONCLUSION: MS-AFP level in the second trimester is still an important indicator of fetal surface malformations; however, ultrasound still outweighs as a screening method. Nevertheless, pregnant women with elevated MS-AFP values and with no sonographically detected fetal malformations should additionally receive the third trimester ultrasound examination to exclude other possible complications of pregnancy.

Body size of newborns in relation to mother's ethnicity and education: a pilot study from Vilnius City (Lithuania), 2005-2010.

The purpose of this study was to analyse body size indices of newborns in Vilnius city (Lithuania) during 2005-2010 in relation with mother's education and ethnicity, and in parallel with the changes of socio-economic situation during the recent years. The present results were based on data (N = 18,084) from the Vilnius University Clinic of Obstetrics and Gynaecology. Comparison of the present Lithuanian data with other newborn studies was made. The analysis of socio-economic and demographic indicators of Lithuania, and the comparison of Gross Domestic Product of various countries was performed. The comparison of body size of newborns' data from the different countries showed that Lithuanian newborns were among the biggest babies. Some statistically significant differences in body size of newborns from different ethnic groups were established. Body length of Lithuanian newborns (M = 52.6 cm, SD = 2.5) was higher than length of Russian, Ukrainian and Romanian newborns. Body weight of Lithuanian newborns (M = 3511 g, SD = 485) was bigger than birth weight of Russian, Polish, Ukrainian and Romanian newborns. The analysis of newborns size by mother's education showed that body weight of neonates from mothers with the university education and from each other education group was bigger in comparison with the babies from respectively lower education group. The comparison of newborns weight by mother's ethnicity in relation to education level revealed nearly no discrepancies between size of newborns from mothers with the same education level at different ethnic group. The analysis of birth parameters by year has not established a statistically significant difference between the mean values for the body weight and body length of the whole investigated contingent of the full-term, single-birth newborns from Vilnius city during the 2005-2010. However, the tendency has been revealed that newborns from mothers with lower education were the most susceptible to negative economic changes after the 2008.