Screening for adverse perinatal outcome by biomarkers in maternal serum; a comparison of elevated maternal serum alpha-fetoprotein versus human chorionic gonadotropin

We conducted a cohort analytic study to determine whether an unexplained increase in maternal serum alpha-fetoprotein (MSAFP) or human chorionic gonadotropin (MShCG) is effective in screening for adverse perinatal outcomes. MSAFP and MShCG levels were measured in 1,097 consecutive pregnant women in whom gestation was dated by ultrasonography and who later delivered a single infant. Patients with high MSAFP or MShCG had a much higher risk of low birth weight, intrauterine growth retardation and fetal death. But a screening test with MShCG for predicting preterm birth, low birth weight and intrauterine growth retardation had an approximately twice higher sensitivity than that with MSAFP. A combination of MSAFP and MShCG had little effect on the sensitivity. We concluded that a screening test with MShCG alone might be useful in predicting adverse perinatal outcomes.