Association between alpha-fetoprotein levels during the second trimester of pregnancy and the incidence of low birth weight infants at Sunpasitthiprasong Hospital
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Abstract
Objective: To evaluate the association between maternal serum alpha-fetoprotein (MSAFP) levels during the second trimester and low birth weight (LBW) incidence, at Sunpasitthiprasong Hospital.
Materials and Methods: This retrospective cohort study included 1,937 pregnant women who underwent chromosomal abnormality screening between June 2021 and May 2025. Data from medical records included maternal baseline characteristics, antenatal history, Quadruple test results, and delivery outcomes. Univariable and multivariable analyses were performed using logistic regression. Predictive performance of MSAFP for LBW was assessed by receiver operating characteristic (ROC) curve analysis.
Results: The mean age of pregnant women was 28.5±5.4 years. Birthweight less than 2,500 grams was observed in 10.9% of infants. The Quadruple test was positive in 7.4% of cases. The median MSAFP levels were 34.36 ng/mL (IQR 26.94, 45.30), converting to 1.01 MoM (IQR 0.83, 1.28). MSAFP levels were significantly higher in the LBW group compared to the non-LBW group (median 37.33 vs. 34.12 ng/mL). In multivariable analysis, MSAFP in ng/mL, MoM, and > 2.0 MoM was significantly associated with LBW (Adj.OR 1.01, 1.34, and 2.52 respectively). However, serum AFP demonstrated low predictive performance for LBW (AUC=0.566).
Conclusion: MSAFP levels were significantly correlated with LWB, with higher levels observed in pregnancies with LBW. However, its predictive performance was low, limiting clinical utility. Elevated MSAFP may indicate risk to LBW but should be evaluated alongside other maternal and biochemical factors for effective risk assessment.
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