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Increased midtrimester amniotic fluid activin A: a risk factor for subsequent fetal death.

Increased midtrimester amniotic fluid activin A: a risk factor for subsequent fetal death.

Authors :
Petraglia F
Gomez R
Luisi S
Florio P
Tolosa JE
Stomati M
Romero R
Source :
American journal of obstetrics and gynecology [Am J Obstet Gynecol] 1999 Jan; Vol. 180 (1 Pt 1), pp. 194-7.
Publication Year :
1999

Abstract

Objective: The objective of this study was to determine whether concentrations of activin A and corticotropin-releasing factor in amniotic fluid can identify patients at risk of fetal death.<br />Study Design: A retrospective case-control study of women who have had a midtrimester amniocentesis was designed. Case subjects consisted of patients who had a spontaneous fetal death after the procedure, whereas the control group consisted of patients who had a normal pregnancy outcome after midtrimester amniocentesis. Dimeric activin A was measured by a specific 2-site enzyme immunoassay, and corticotropin-releasing factor was measured by a specific and sensitive radioimmunoassay after acidic extraction. Statistical analysis was performed with Mann-Whitney U test, Fisher's exact test, and chi2 tests and regression analysis.<br />Results: First, activin A was detectable in all amniotic fluid samples. Second, the concentration of activin A in amniotic fluid increased with advancing gestational age. Third, patients who subsequently had a fetal death had a higher median concentration of activin A than those with a normal pregnancy outcome (P <.01). Fourth, an amniotic fluid concentration of activin A greater than the 95th confidence interval for gestational age was found in 40% of patients who subsequently had a fetal death (odds ratio: 21.6; P <.005). Finally, the median concentration of corticotropin-releasing factor in amniotic fluid was not different in case subjects and control subjects.<br />Conclusions: An elevated concentration of activin A in amniotic fluid identifies women at risk of fetal death.

Details

Language :
English
ISSN :
0002-9378
Volume :
180
Issue :
1 Pt 1
Database :
MEDLINE
Journal :
American journal of obstetrics and gynecology
Publication Type :
Academic Journal
Accession number :
9914603
Full Text :
https://doi.org/10.1016/s0002-9378(99)70174-2