The outcome in infants without fetal neural tube defect born to mothers with elevated maternal serum α-fetoprotein was studied. Elevated maternal serum α-fetoprotein with normal amniotic fluid α-fetoprotein was found to be associated with an increased incidence of intrauterine growth retardation and nonneural tube congenital anomalies. There was no increased incidence of developmental disabilities in infants born to mothers with elevated maternal serum α-fetoprotein. It is speculated that adverse events occurring early in gestation may simultaneously result in congenital anomalies and subsequently elevated maternal serum α-fetoprotein, perhaps through disruption of the normal placental barrier between the fetal and maternal circulations.
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