PubMed · 2004 · 10 citations · 0 references
The median of MSAFP level for deliveries with no congenital anomalies were 25.5, 33.5, and 53.2 IU/ml, at gestational weeks 16, 17 and 18 respectively. The significant variables related positively to MSAFP level included abortion or stillbirth, congenital anomalies in the index pregnancy, gestational age, bleeding during pregnancy, gestational diabetes, twin pregnancy, consanguinity between maternal parents, history of congenital or genetic diseases in maternal family, and caesarian section deliveries. Fatigue score was negatively correlated to MSAFP level. Using MSAFP multiples of median (MOM), 42.9 % of abortions and stillbirths, 57.1 % of twin pregnancies, 31.25 % of preterm deliveries and 27.3 % of low birth weight had levels of 3 MOM or more. One fourth of the congenital anomalies were below 0.5 MOM and 41.7 % were at or above 3 MOM. The sensitivity of MSAFP test for the detection of NTDs (cutoff point 2.5+ MOM) or Down syndrome (cutoff point <0.5 MOM) among the study sample was 100% (CI: 19.8-100%). Specificity for NTDs was 92.7% (CI: 90.3-94.6%), while the specificity for Down syndrome was 89.1% (86.3-91.4%). The sensitivity for adverse pregnancy outcome (cutoff point <0.5 or 2.5+ MOM) was 41.6, and the specificity was 85.8%. In conclusion, the cutoff points of MSAFP of the study sample are different from those for other populations. Different factors affect the level of MSAFP including adverse pregnancy outcomes. It is recommended to introduce antenatal screening for congenital anomalies as a routine screening test during pregnancy using levels adapted from the local population for cutoff point determination.