The relationship between second trimester alpha  fetoprotein levels and adverse pregnancy outcome

Allen, Ruth; Marleen, Shemoon; Velauthar, Luxmi; Harrington, Kevin; Aquilina, J.

doi:10.4236/ojog.2013.32049

Cited by 6 publications

(5 citation statements)

References 21 publications

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“…The most significant altered gene was Alfa-fetoprotein (AFP), a major foetal plasma protein produced by the yolk sac and the liver. This glycoprotein is widely used as a maternal serum protein biomarker of Down syndrome and adverse perinatal outcome (Pennings et al 2009, Allen et al 2013. However, we observed the mRNA expression of this gene in the foetal placenta, indicating that this tissue could also contribute to the elevated levels commonly associated with developmental foetus alterations.…”

Section: Discussionmentioning

confidence: 71%

Vitrification alters rabbit foetal placenta at transcriptomic and proteomic level

Saenz-de-Juano¹,

Marco‐Jiménez²,

Schmaltz-Panneau³

et al. 2014

Reproduction

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Although numerous studies have demonstrated that cryopreservation alters gene expression, less is known about those embryos that implanted successfully and continued in gestation. To raise the question of the neutrality of this technique, we examine the effects of vitrification through gestation in rabbit before and after the implantation. We monitored the distribution of losses of 569 vitrified morulae, observing that embryos which reach the last pre-implantatory stage are able to implant. However, we found that not all implanted embryos had the ability to continue with their gestation. The results reveal that vitrification decreased foetus and maternal placenta weights at mid-gestation, but led to a higher offspring birth weight. A novel finding is that while no differences in gene expression were detected in pre-implantatory embryos at day 6, vitrification affects a gene and protein expression in the placenta at day 14. Our results for first time reveal strong evidence of modifications in implanted embryos subjected to vitrification, suggesting that the crucial step that vitrified embryos must overcome is the placenta formation. On the basis of these findings, our work leaves the question open as to whether the effects we observed that cause vitrification during foetal development could give rise to some type of physiological or metabolic alteration in adulthood.

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Section: Discussionmentioning

confidence: 71%

Vitrification alters rabbit foetal placenta at transcriptomic and proteomic level

Saenz-de-Juano¹,

Marco‐Jiménez²,

Schmaltz-Panneau³

et al. 2014

Reproduction

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“…The total number of fetuses present in Dahl S dams on both day 10 (10 Ϯ 1 vs. 13 Ϯ 1, P Ͻ 0.05, n ϭ 7-12) and day 14 (11 Ϯ 1 vs. 14 Ϯ 1, P Ͻ 0.05, n ϭ 7-11) was significantly lower compared with SD by unpaired t-test with Welch's correction. Two out of seven of the Dahl S dams examined on day 14 had evidence of fetal resorptions (3,5). A subset of these samples were used in an unbiased microarray approach, using Affymetrix GeneChip Microarrays, to identify genes that changed in the uterine tissue during healthy and preeclamptic pregnancy.…”

Section: Resultsmentioning

confidence: 99%

Spontaneous superimposed preeclampsia: chronology and expression unveiled by temporal transcriptomic analysis

Maeda

Showmaker

Johnson

et al. 2019

Physiological Genomics

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Preeclampsia (PE), a multifactorial pregnancy-specific syndrome accounting for up to 8% of pregnancy complications, is a leading cause of maternal and fetal morbidity and mortality. PE is also associated with long-term risk of hypertension and stroke for both mother and fetus. Currently, the only “cure” is delivery of the baby and placenta, largely because the pathogenesis of PE is not yet fully understood. PE is associated with impaired vascular remodeling at the maternal-fetal interface and placental insufficiency; however, specific factors contributing to this impairment have not been identified. To identify molecular pathways involved in PE, we examined temporal transcriptomic changes occurring within the uterus, uterine implantation sites, and placentae from the Dahl salt-sensitive (Dahl S) rat model of superimposed PE compared with Sprague Dawley (SD) rats. We hypothesized that targeted gene analysis and whole transcriptome analysis would identify genetic factors that contribute to development of the preeclamptic phenotype in the Dahl S rat and unveil novel biomarkers, therapeutic targets, and mechanistic pathways in PE. Quantitative real-time PCR (qRT-PCR) and whole genome microarray analysis were performed on isolated total RNA from uterus ( day 0), uterine implantation sites ( days 7 and 10), and placenta ( days 14 and 20). We found 624, 332, 185, and 366 genes to be differentially expressed between Dahl S (PE) and SD (normal pregnancy) on days 0, 7, 10, and 14, respectively. Our data revealed numerous pathways that may play a role in the pathophysiology of spontaneous superimposed PE and allow for further investigation of novel therapeutic targets and biomarker development.

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“…This further strengthens the possible role of AFP as potential markers of severity in PIH as suggested by other studies. [5,20] Multiple linear regression analysis showed that serum AFP increased as birth weights reduced (Table 12). Serum AFP had significant association with BMI and Apgar scores when adjusted for other variables.…”

Section: Discussionmentioning

confidence: 99%

“…[3] Amidst numerous biomarkers studied in pre-eclampsia, unexplained elevation of maternal serum alpha-fetoprotein (MSAFP), as a marker of placenta dysfunction, has also been associated with several placenta-mediated adverse pregnancy outcomes, including pregnancy induced hypertension, intrauterine growth restriction, and stillbirth. [4] Despite significant association of MSAFP with severity of pregnancy induced hypertension and poor fetal outcome noted in some studies, [5][6][7] this has not been uniformly accepted or confirmed across different populations. [8,9] While the prevention of the disease is still elusive, it seems possible that some biomarkers like AFP may correlate with disease severity and help predict adverse pregnancy outcome in pregnancy induced hypertension.…”

Section: Introductionmentioning

confidence: 99%

Alpha Fetoprotein as a Marker of Severe Disease and Foetal Outcome in Pregnancy Induced Hypertension

Olumodeji

Adewara²,

Adeyemo³

et al. 2019

ijirms

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Background: Pregnancy-induced hypertension represents the most common medical complication of pregnancy and contributes significantly to maternal and neonatal morbidity and mortality. Many theories have been implicated in its genesis, crucial among which is the defective 2nd wave of trophoblastic invasion/placentation. Maternal serum alpha fetoprotein is a marker of placental abnormalities and may correlate with clinical features of significant management implications. This study evaluated the role of maternal Alpha-fetoprotein concentration as a marker of disease severity and foetal outcome in patients with pregnancy induced hypertension at the Federal Teaching Hospital, Ido-Ekiti, Ekiti state, Nigeria. Methodology: This was a prospective study in which 44 patients with PIH and 88 matched controls that satisfied the inclusion criteria were recruited using convenience sampling technique for cases and systematic random sampling for controls. Relevant socio-demographic, maternal medical and obstetric characteristics, alpha-fetoprotein levels and fetal outcome measures were obtained. A p-value of less than 0.05 was considered statistically significant. SPSS 20.0 statistical package (SPSS Inc, Chicago, IL, USA) was used for statistical analysis. Results: The prevalence of PIH in the study was 15.3%. The difference in the mean (±2SD) serum level of alpha fetoprotein (AFP) between the cases (207±156.2ng/ml) and control group (165.2±115.1ng/ml) was not statistically significant (p=0.079). The mean (±2SD) birth weight of babies born to women with PIH in this study was 2.7±0.6kg which was significantly lower (p<0.001; 95%CI 3.0 – 3.1)) than the mean birth weights of 3.2±0.4kg of babies of normotensive controls. The mean (± 2SD) Apgar scores at both 1 minute and 5 minutes were both significantly lower in the PIH group (6.7±1.8 and 8.4±1.5 respectively) than among the normotensive women (7.6±1.2 and 8.9±1.1 respectively). Thirty-one point eight percentage of babies born to women in the PIH group and 11.4% of babies of normotensive controls required admission into special care baby unit (SCBU) (Odds Ratio=1.17; 95%CI (0.24-5.76) Serum AFP had a reasonable negative correlation with both birth weight (r=-0.47, p=0.001) and Apgar score at 5 minute (r=-0.44, p=0.002). At 2 MoM serum AFP level, sensitivity and specificity for severe PIH were 36% and 90% respectively. Conclusion: Maternal serum AFP levels showed reasonable positive correlation with disease severity and adverse fetal outcome that warrants further investigation. Maternal serum AFP can be useful in identifying pregnant women with PIH at risk of having severe disease and adverse foetal outcome.

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The relationship between second trimester alpha fetoprotein levels and adverse pregnancy outcome

Cited by 6 publications

References 21 publications

Vitrification alters rabbit foetal placenta at transcriptomic and proteomic level

Vitrification alters rabbit foetal placenta at transcriptomic and proteomic level

Spontaneous superimposed preeclampsia: chronology and expression unveiled by temporal transcriptomic analysis

Alpha Fetoprotein as a Marker of Severe Disease and Foetal Outcome in Pregnancy Induced Hypertension

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