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

F. Petraglia, R. Gomez, S. Luisi, P. Florio, J. E. Tolosa, M. Stomati, R. Romero

Research output: Contribution to journalArticle

23 Scopus citations

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. 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 χ2 tests and regression analysis. 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. CONCLUSIONS: An elevated concentration of activin A in amniotic fluid identifies women at risk of fetal death.

Original languageEnglish (US)
Pages (from-to)194-197
Number of pages4
JournalAmerican journal of obstetrics and gynecology
Volume180
Issue number1 I
DOIs
StatePublished - Jan 1 1999

Keywords

  • Activin A
  • Amniocentesis
  • Amniotic fluid
  • Corticotropin-releasing factor
  • Fetal death

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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