Maternal Age-Dependent and Sex-Related Changes of Gestational Serum Alpha-Fetoprotein

Szabó, Mária; Veress, L; Münnich, Ákos; Papp, Zoltán

doi:10.1159/000264260

Cited by 15 publications

(11 citation statements)

References 9 publications

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“…Some studies have reported that in the second trimester among pregnancies with a female fetus there is a signi®cantly lower maternal serum AFP and higher hCG level than with a male fetus (Leporrier et al, 1992;Szabo et al, 1995;Bazzett et al, 1998). That same trend is found in our ®rst trimester data.…”

Section: Discussionsupporting

confidence: 89%

Co-variables in first trimester maternal serum screening

et al. 2000

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The objective of this study was to determined the influence of maternal weight, maternal smoking habits, gravidity, parity and fetal gender on the level of maternal serum marker used in first trimester screening for Down syndrome. A total of 2449 singleton unaffected pregnancies from two centres were studied. Maternal serum free beta-human chorionic gonadotrophin (hCG) and alpha-fetoprotein (AFP) concentrations had been measured in all pregnancies, and pregnancy associated plasma protein (PAPP)-A levels had been measured in 924. All results were expressed as multiples of the gestation specific median (MoM) values after regression, using each centre's own medians. Information on maternal weight was available in 2259 pregnancies, on self-reported current cigarette smoking in 1364 (of whom 117 (8.6%) were smokers), on gravidity in 1371, parity in 1303 and fetal gender in 253. All three markers showed a statistically significant negative association with maternal weight (p<0.0005) and in the subsequent analyses MoM values were weight adjusted using standard methods. The median PAPP-A level in smokers was 0.81 MoM, a significant reduction (p<0.005); free beta-hCG was also reduced (median 0.89 MoM) but not significantly (p=0.17), and AFP was unaltered. The median AFP level in primagravidas was highly significantly greater than that in gravid women (p<0.0005). In PAPP-A the reverse effect was seen but it did not reach statistical significance (p=0.15) and there was no effect for free beta-hCG. Results of a similar magnitude and direction were found for parity. The median level of free beta-hCG was higher (p=0.0005), and the median AFP lower in female pregnancies. Maternal weight and, for PAPP-A, maternal smoking are important first trimester screening co-variables. Gravidity, parity and fetal gender also seem to influence one or more first trimester markers.

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Section: Discussionsupporting

confidence: 89%

Co-variables in first trimester maternal serum screening

et al. 2000

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“…In addition to differences in pregnancy-related hormones, male bearers have higher serum levels of a-fetoprotein than female bearers (13,57,58). However, (1) and (2), between bearing male offspring and ovarian cancer risk.…”

Section: Offspring Gender and Maternal Risk Of Ovarian Cancer Cancer mentioning

confidence: 99%

Gender of Offspring and Maternal Risk of Invasive Epithelial Ovarian Cancer

Baik¹,

Lambe²,

Liu³

et al. 2007

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Gender of a fetus is associated with maternal hormonal milieu and may therefore modify maternal risk of ovarian cancer following a birth. We evaluated the relation between gender of offspring and maternal risk of epithelial ovarian cancer in a large casecontrol study nested within a nationwide cohort. Cohort members were identified in the Swedish Fertility Register. Cases of invasive epithelial ovarian cancer were identified in the Swedish National Cancer Register from 1961 to 2001. Five controls were matched by age to each case. A total of 7,407 cases and 37,658 controls with only singleton births were included in the analysis. We fit logistic regression models to study the association between gender of offspring and ovarian cancer risk, controlling for covariates. Maternal risk of ovarian cancer was reduced with increasing numbers of male offspring and increased with number of female offspring. Compared with women who gave birth to only girls, multivariate odds ratios (95% confidence interval) of invasive epithelial ovarian cancer were 0.92 (0.87-0.98) for those who gave birth to one boy, 0.87 (0.80-0.94) for two boys, and 0.82 (0.73-0.94) for three or more boys (P value test for trend < 0.001). There was a positive but nonsignificant association with number of girls. Similar results were observed when restricting the analysis to women born before 1935. Our findings suggest that hormonal and physiologic conditions in pregnancy with male, but not with female, offspring are associated with a lowered maternal risk of invasive epithelial ovarian cancer. (Cancer Epidemiol Biomarkers Prev 2007;16(11):2314 -20)

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“…The reported [1][2][3][4] higher alphafetoprotein levels in maternal serum in pregnancies with a male fetus is probably the result of some modification of alpha-fetoprotein transfer into the maternal circulation, possibly mediated by fetal sex.…”

Section: Discussionmentioning

confidence: 95%

“…Fetal sex has been noted to affect alpha-fetoprotein concentration in maternal serum -significantly higher alpha-fetoprotein levels have been reported in pregnan cies with a male fetus [1][2][3][4], This effect, which is appar ently true in both the second and the third trimesters [2,3], is not correlated with parity, maternal age, maternal weight or weight gain or with fetal weight [3], Higher alpha-fetoprotein levels in the serum of gravi das carrying a male fetus may result either from sex-spe cific hormonal influences on transcription of the alpha- This article is also accessible online at: http:// www. karger, ch http://BioMedNct.com / karger fetoprotein gene (increased production) or from increased transfer of alpha-fetoprotein into the maternal circulation in male gestations.…”

Section: Introductionmentioning

confidence: 99%

No Effect of Fetal Sex on Amniotic Fluid Alpha-Fetoprotein

et al. 1997

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Objective: To evaluate the effect of fetal sex on the concentration of amniotic fluid alpha-fetoprotein (AF-AFP) in singletons and twins. Material and Methods: Amniocentesis was performed for advanced maternal age between 15 and 20 weeks of gestation. Only patients with normal karyotypes, uncomplicated gestations and normal ultrasound examination were included. AFP was measured in amniotic fluid by RIA and results, expressed as multiples of the median (MoM), were grouped according to fetal sex and were compared by t test. Results: A total of 603 singleton pregnancies (294 females and 309 males) and 45 twin pregnancies discordant for sex met the inclusion criteria. The mean AF-AFP in singleton males was 1.06 vs. 1.04 MoM in singleton females. In twins, the mean AF-AFP was, respectively, 1.05 and 1.07 MoM (p > 0.05). Conclusion: Gender had no impact on AF-AFP in singleton or twin pregnancies, suggesting that the differential influence of sex hormones on the activity of the AFP gene is negligible.

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Maternal Age-Dependent and Sex-Related Changes of Gestational Serum Alpha-Fetoprotein

Cited by 15 publications

References 9 publications

Co-variables in first trimester maternal serum screening

Co-variables in first trimester maternal serum screening

Gender of Offspring and Maternal Risk of Invasive Epithelial Ovarian Cancer

No Effect of Fetal Sex on Amniotic Fluid Alpha-Fetoprotein

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