Maternal serum α-fetoprotein and human chorionic gonadotropin levels in women with human immunodeficiency virus

Objective: The purpose of this study was to establish whether there is a correlation between maternal serum genetic screen analyte results in pregnant women with human immunodeficiency virus and corresponding human immunodeficiency virus index values. Study Design: Medical records of all pregnant women with human immunodeficiency virus who were delivered at Bronx Lebanon Hospital Center from January 2000 through December 2001 were reviewed for maternal serum screen results, viral load, CD4 counts and percent, antiretroviral therapy, opportunistic infections, substance abuse, and other demographic data. Statistical analysis was accomplished with the χ2 test, Mann-Whitney U test, and Spearman rank correlation test, with a probability value of <.05 considered significant. Results: Of the 98 women with human immunodeficiency virus who were delivered, 49 women (50%) had a maternal serum genetic screen available. Screened and unscreened women had similar severity of human immunodeficiency virus disease, CD4 count and percentage, and viral loads. Serum screen results showed elevations in maternal serum human chorionic gonadotropin (1.43 ± 1.04 multiples of the median [MoM]; range, 0.2-5.2 MoM) and maternal serum α-fetoprotein (1.29 ± 0.9 MoM; range, 0.5-3.3 MoM) compared with expected values in the general obstetric population. Maternal serum human chorionic gonadotropin was correlated inversely with CD4 count (P= .002) and CD4 percent (P< .0001). Maternal serum α-fetoprotein varied directly with viral load (P< .0001). Conclusion: Increasing maternal serum human chorionic gonadotropin and maternal serum α-fetoprotein levels in patients with human immunodeficiency virus are correlated with increasing viral load and decreasing CD4 counts. (Am J Obstet Gynecol 2003;188:1052-6.)