The effects on fetal development of high alpha-fetoprotein and maternal smoking

Objectives. This study determined the risk of impaired fetal growth resulti ng from the interaction between maternal smoking during pregnancy and unexp lained elevated concentrations of maternal serum alpha-fetoprotein (MSAFP). Methods. This observational study involved 123 pregnant smokers with unexpl ained second-trimester elevated concentrations of MSAFP, 827 smokers with n ormal levels, and 471 nonsmokers with raised levels. Results. By logistic regression, coincident smoking and elevated MSAFP leve ls were found to be associated with increases in the low basic risks of pre maturity small-for-gestational-age births, low birthweight, and need for ne onatal care. Conclusions. Maternal smoking has an adverse effect on fetal development in pregnancies with unexplained elevated MSAFP concentrations. Such pregnanci es merit close surveillance.