Pregnant women with elevated maternal serum alpha-fetoprotein in a health area of ​​Las Tunas, Cuba, 2020–2022

Abstract

Introduction: maternal serum alpha-fetoprotein is a biochemical marker used in the prenatal screening of congenital defects, particularly neural tube defects. However, elevated levels are also associated with various maternal and fetal factors, and in many cases, no apparent cause is identified.

Objective: to characterize pregnant women with abnormal maternal serum alpha-fetoprotein levels who received care at the “Manuel Piti Fajardo” polyclinic in the Las Tunas municipality between July 2020 and December 2022.

Methods: adescriptive cross-sectional study was conducted with a sample of 210 pregnant women whose maternal serum alpha-fetoprotein levels were ≥2.0 multiples of the median. The variables analyzed included maternal age, nutritional status, substance use (toxic habits), maternal serum alpha-fetoprotein levels, multiples of the median, diagnosed congenital defects, and associated risk factors. Descriptive statistics were used.

Results: the majority of the pregnant women were between 20 and 34 years old (69.0%), had a normal body weight (61.9%), and reported no substance use (88.6 %). Maternal serum alpha-fetoprotein levels were primarily in the range of 2.0–3.0 multiples of the median (67.1 %). Only five congenital defects were diagnosed (2.4 %), half of which were neural tube defects in older pregnant women. The most frequent risk factors were exposure to teratogenic agents (20.9 %), low maternal weight (20.9 %), adolescence (18.6%), familial chromosomal abnormalities (13.3 %), and advanced maternal age (12.4 %).

Conclusions: the study indicates that most cases were not associated with congenital defects, which underscores the need for comprehensive follow-up that extends beyond the diagnosis of malformations.