Elevation of maternal alpha-fetoprotein in systemic lupus erythematosus: A controlled study

Michelle Petri, A. C. Ho, J. Patel, D. Demers, J. Mehsen Joseph, Daniel Goldman

Research output: Contribution to journalArticle

Abstract

Objective. To determine if maternal alpha fetoprotein (AFP) is elevated in lupus pregnancy and, if so, whether it is associated with treatment or outcome. Methods. Maternal serum AFP values were obtained once during Weeks 16.3 to 31.7 in 54 pregnancies followed prospectively. AFP was measured by the Maryland State Health Department, who reported the AFP level and a corrected value, multiple of the median (AFP MOM), adjusted for weight, gestational age, and insulin dependent diabetes. Controls were 1001 consecutive samples measured by the same laboratory. Results. AFP MOM was higher in lupus pregnancies (1.425 ± 0.73 vs 1.169 ± 0.50, p = 0.001), as were the unadjusted AFP levels (lupus 68.26 ± 42.2, control 52.49 ± 27.25, p = 0.001). Of lupus pregnancies 7.4 vs 2.6% of control pregnancies had an abnormal AFP MOM (p = 0.06). The 4 patients with abnormal AFP-MOM, using the 2.3 cutoff, were taking more prednisone (27.25 ± 18.54 mg vs 10.85 ± 12.29 mg, p = 0.02), were more likely to have delivered preterm (31.50 vs 36.31 weeks, p = 0.02), and were more likely to have a high anticardiolipin (aCL) antibody during the pregnancy (p = 0.03). Conclusion. AFP is higher in lupus than in control pregnancies, without any increase in neural tube or other birth defects. An abnormal maternal serum AFP level is associated with higher prednisone dose, preterm delivery and aCL. Patients and obstetricians need to be aware that an elevated maternal AFP in lupus pregnancy is not necessarily due to a birth defect, and may be predictive of preterm delivery.

Original languageEnglish (US)
Pages (from-to)1365-1368
Number of pages4
JournalJournal of Rheumatology
Volume22
Issue number7
StatePublished - 1995

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alpha-Fetoproteins
Systemic Lupus Erythematosus
Mothers
Pregnancy
Prednisone
Anticardiolipin Antibodies
Neural Tube
Serum
Gestational Age
Insulin

Keywords

  • Alpha fetoprotein
  • Antiphospholipid antibody
  • Pregnancy
  • Systemic lupus erythematosus

ASJC Scopus subject areas

  • Immunology
  • Rheumatology

Cite this

Elevation of maternal alpha-fetoprotein in systemic lupus erythematosus : A controlled study. / Petri, Michelle; Ho, A. C.; Patel, J.; Demers, D.; Mehsen Joseph, J.; Goldman, Daniel.

In: Journal of Rheumatology, Vol. 22, No. 7, 1995, p. 1365-1368.

Research output: Contribution to journalArticle

Petri, M, Ho, AC, Patel, J, Demers, D, Mehsen Joseph, J & Goldman, D 1995, 'Elevation of maternal alpha-fetoprotein in systemic lupus erythematosus: A controlled study', Journal of Rheumatology, vol. 22, no. 7, pp. 1365-1368.
Petri, Michelle ; Ho, A. C. ; Patel, J. ; Demers, D. ; Mehsen Joseph, J. ; Goldman, Daniel. / Elevation of maternal alpha-fetoprotein in systemic lupus erythematosus : A controlled study. In: Journal of Rheumatology. 1995 ; Vol. 22, No. 7. pp. 1365-1368.
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abstract = "Objective. To determine if maternal alpha fetoprotein (AFP) is elevated in lupus pregnancy and, if so, whether it is associated with treatment or outcome. Methods. Maternal serum AFP values were obtained once during Weeks 16.3 to 31.7 in 54 pregnancies followed prospectively. AFP was measured by the Maryland State Health Department, who reported the AFP level and a corrected value, multiple of the median (AFP MOM), adjusted for weight, gestational age, and insulin dependent diabetes. Controls were 1001 consecutive samples measured by the same laboratory. Results. AFP MOM was higher in lupus pregnancies (1.425 ± 0.73 vs 1.169 ± 0.50, p = 0.001), as were the unadjusted AFP levels (lupus 68.26 ± 42.2, control 52.49 ± 27.25, p = 0.001). Of lupus pregnancies 7.4 vs 2.6{\%} of control pregnancies had an abnormal AFP MOM (p = 0.06). The 4 patients with abnormal AFP-MOM, using the 2.3 cutoff, were taking more prednisone (27.25 ± 18.54 mg vs 10.85 ± 12.29 mg, p = 0.02), were more likely to have delivered preterm (31.50 vs 36.31 weeks, p = 0.02), and were more likely to have a high anticardiolipin (aCL) antibody during the pregnancy (p = 0.03). Conclusion. AFP is higher in lupus than in control pregnancies, without any increase in neural tube or other birth defects. An abnormal maternal serum AFP level is associated with higher prednisone dose, preterm delivery and aCL. Patients and obstetricians need to be aware that an elevated maternal AFP in lupus pregnancy is not necessarily due to a birth defect, and may be predictive of preterm delivery.",
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T1 - Elevation of maternal alpha-fetoprotein in systemic lupus erythematosus

T2 - A controlled study

AU - Petri, Michelle

AU - Ho, A. C.

AU - Patel, J.

AU - Demers, D.

AU - Mehsen Joseph, J.

AU - Goldman, Daniel

PY - 1995

Y1 - 1995

N2 - Objective. To determine if maternal alpha fetoprotein (AFP) is elevated in lupus pregnancy and, if so, whether it is associated with treatment or outcome. Methods. Maternal serum AFP values were obtained once during Weeks 16.3 to 31.7 in 54 pregnancies followed prospectively. AFP was measured by the Maryland State Health Department, who reported the AFP level and a corrected value, multiple of the median (AFP MOM), adjusted for weight, gestational age, and insulin dependent diabetes. Controls were 1001 consecutive samples measured by the same laboratory. Results. AFP MOM was higher in lupus pregnancies (1.425 ± 0.73 vs 1.169 ± 0.50, p = 0.001), as were the unadjusted AFP levels (lupus 68.26 ± 42.2, control 52.49 ± 27.25, p = 0.001). Of lupus pregnancies 7.4 vs 2.6% of control pregnancies had an abnormal AFP MOM (p = 0.06). The 4 patients with abnormal AFP-MOM, using the 2.3 cutoff, were taking more prednisone (27.25 ± 18.54 mg vs 10.85 ± 12.29 mg, p = 0.02), were more likely to have delivered preterm (31.50 vs 36.31 weeks, p = 0.02), and were more likely to have a high anticardiolipin (aCL) antibody during the pregnancy (p = 0.03). Conclusion. AFP is higher in lupus than in control pregnancies, without any increase in neural tube or other birth defects. An abnormal maternal serum AFP level is associated with higher prednisone dose, preterm delivery and aCL. Patients and obstetricians need to be aware that an elevated maternal AFP in lupus pregnancy is not necessarily due to a birth defect, and may be predictive of preterm delivery.

AB - Objective. To determine if maternal alpha fetoprotein (AFP) is elevated in lupus pregnancy and, if so, whether it is associated with treatment or outcome. Methods. Maternal serum AFP values were obtained once during Weeks 16.3 to 31.7 in 54 pregnancies followed prospectively. AFP was measured by the Maryland State Health Department, who reported the AFP level and a corrected value, multiple of the median (AFP MOM), adjusted for weight, gestational age, and insulin dependent diabetes. Controls were 1001 consecutive samples measured by the same laboratory. Results. AFP MOM was higher in lupus pregnancies (1.425 ± 0.73 vs 1.169 ± 0.50, p = 0.001), as were the unadjusted AFP levels (lupus 68.26 ± 42.2, control 52.49 ± 27.25, p = 0.001). Of lupus pregnancies 7.4 vs 2.6% of control pregnancies had an abnormal AFP MOM (p = 0.06). The 4 patients with abnormal AFP-MOM, using the 2.3 cutoff, were taking more prednisone (27.25 ± 18.54 mg vs 10.85 ± 12.29 mg, p = 0.02), were more likely to have delivered preterm (31.50 vs 36.31 weeks, p = 0.02), and were more likely to have a high anticardiolipin (aCL) antibody during the pregnancy (p = 0.03). Conclusion. AFP is higher in lupus than in control pregnancies, without any increase in neural tube or other birth defects. An abnormal maternal serum AFP level is associated with higher prednisone dose, preterm delivery and aCL. Patients and obstetricians need to be aware that an elevated maternal AFP in lupus pregnancy is not necessarily due to a birth defect, and may be predictive of preterm delivery.

KW - Alpha fetoprotein

KW - Antiphospholipid antibody

KW - Pregnancy

KW - Systemic lupus erythematosus

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