Alpha-fetoprotein, human placental lactogen, and pregnancy-specific beta 1-glycoprotein in pregnant women who drink: relation to fetal alcohol syndrome.

To determine the usefulness of the assays of maternal serum alpha-fetoprotein, human placental lactogen, and pregnancy-specific beta 1-glycoprotein in prenatal diagnosis of fetal alcohol syndrome, these proteins were followed in 35 problem drinkers (greater than 100 gm of ethanol weekly) and in 14 abstinent women throughout gestation. Thirteen women gave birth to infants with fetal alcohol syndrome, and these women had low levels of alpha-fetoprotein and pregnancy-specific beta 1-glycoprotein but levels of human placental lactogen were normal. Low alpha-fetoprotein correctly predicted fetal alcohol syndrome in 59% with a relative risk of 2.46. Low pregnancy-specific beta 1-glycoprotein predicted fetal alcohol syndrome in 56%, and a relative risk was 3.29. Low alpha-fetoprotein and pregnancy-specific beta 1-glycoprotein may reflect primary or secondary effects of ethanol abuse in pregnancy and appear to be useful in predicting fetal alcohol syndrome.