Utilidad de la alfafetoproteína sérica materna como parámetro de riesgo del embarazo

Información del artículo

Resumen

Objetivo

Demostrar que las embarazadas con valores elevados, sin justificación aparente, de alfafetoproteína sérica tienen un riesgo mayor de resultados perinatales adversos

Sujetos y métodos

Se estudiaron 43.424 gestantes desde el segundo trimestre del embarazo hasta el parto. Se calculó el riesgo relativo entre los valores de alfafetoproteína en suero materno (AFPSM) y los resultados perinatales siguientes: partos pretérminos, muertes fetales anterior y posterior a la semana 28 de gestación, y recién nacidos con bajo peso

Resultados

Se estudió la influencia de las concentraciones de AFPSM sobre 4 resultados perinatales adversos, observándose en todos ellos una diferencia significativa entre el grupo de gestantes considerado control (AFPSM < 2,5 múltiplos de la mediana [MDM]) y el grupo de riesgo (AFPSM > 2,5 MDM). Se observó un mayor riesgo relativo en las gestantes con muerte fetal anterior a la semana 28 de gestación

Conclusiones

Se ha comprobado que existe una relación entre los valores elevados de AFPSM y el riesgo de un resultado perinatal adverso. Sin embargo, la AFPSM no se puede considerar un marcador de cribado adecuado, por su baja sensibilidad, para seleccionar gestantes con un riesgo elevado de un resultado adverso

Palabras clave:

Alfafetoproteínas

Bajo peso

Parto pretérmino

Muerte fetal

Abstract

Objective

To show that pregnant women with an unexplained maternal serum alphafetoprotein (MSAFP) elevation are at increased risk for adverse perinatal outcomes

Patients and methods

43.424 pregnant women were studied prospectively from the early second trimester until delivery. A risk factor for preterm delivery, fetal death, before and after 28 weeks of gestation, and low birth weight infants was calculated from the clinical history and MSAFP concentrations

Results

In all the groups increasing levels of MSAFP are significatively associated with adverse perinatal outcomes, showing a significative difference with regard to the control group of pregnancies (MSAFP < 2,5 multiples of the median [MDM]). The highest relative risk was observed from pregnancies with fetal death before 28 weeks of gestation

Conclusions

Pregnant women with unexplained elevations of MSAFP are at increased risk for adverse perinatal outcomes. However, the MSAFP, because of its low sensitivity, can not be considered as a screening tool to select this kind of pregnancies

Keywords:

Alpha-fetoprotein

Low birth-weight

Preterm delivery

Fetal death

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El trabajo fue realizado en el Laboratorio de Bioquímica del Hospital San Agustín de Avilés. El presente trabajo ha sido realizado en parte con soporte económico de Roche Diagnostics, España

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