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However, it is unknown whether first-trimester MS-AFP is also predictive of APOs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed the data on the first-trimester MS-AFP levels and pregnancy outcomes of 3325 singleton pregnant women. The cutoff value of 2.5 multiple of the median (MoM) was used to evaluate the risks of APOs regarding MS-AFP. The receiver operating characteristic (ROC) curves were used to evaluate the predictive efficiencies of MS-AFP to these disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 181 pregnancies resulted in preterm birth, 32 in stillbirth, 81 in preeclampsia, and 362 in SGA. Compared to women with MS-AFP\u2009&lt;\u20092.5MoM, those with MS-AFP\u2009\u2265\u20092.5MoM had increased risks (odds ratio, 95% confidence interval) of preterm birth (2.53, 1.65~3.88), preeclampsia (3.05, 1.71~5.43) and SGA (1.90, 1.34~2.69), and had an earlier distribution of gestational weeks at delivery (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.004) and a lower distribution of neonatal birth weights (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.000), but the actual between-group differences were minuscule. The areas under ROC curves were 0.572 (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001), 0.579 (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.015) and 0.565 (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.000) for preterm birth, preeclampsia and SGA, respectively. Subdivisions for the disorders did not obviously improve the performances of MS-AFP.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Elevated first-trimester MS-AFP is associated with increased risk of preterm birth, preeclampsia and SGA. However, the predictive efficiencies were low and it is not a good predictor for these APOs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12884-020-2789-2","type":"journal-article","created":{"date-parts":[[2020,2,12]],"date-time":"2020-02-12T12:02:43Z","timestamp":1581508963000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["First-trimester maternal serum alpha-fetoprotein is not a good predictor for adverse pregnancy outcomes: a retrospective study of 3325 cases"],"prefix":"10.1186","volume":"20","author":[{"given":"Jilin","family":"Hu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinman","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guilin","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shu","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinhua","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Su","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qian","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yamin","family":"Kong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4224-3380","authenticated-orcid":false,"given":"Baosheng","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,2,12]]},"reference":[{"key":"2789_CR1","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1016\/S0140-6736(15)00837-5","volume":"387","author":"JE Lawn","year":"2016","unstructured":"Lawn JE, Blencowe H, Waiswa P, et al. 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