Alpha-fetoprotein: A marker for recurrent apnoea of prematurity?

Plasma alpha-fetoprotein was measured each week for 28 days on 132 preterm babies who were admitted to an intensive care unit. Reference values were established on 53 of these infants who were relatively normal and whose gestations ranged from 29 to 33.9 weeks. Similar studies were done on 79 of the 132 infants with comparable gestational ages who suffered from hyaline membrane disease, transient tachypnoea, recurrent apnoea or growth retardation. Plasma AFP was significantly raised in those with recurrent apnoea but a reason was not established for this observation. The risk of apnoea persisted until AFP levels had reached the reference range.

Infants with hyaline membrane disease had lower levels of plasma AFP than the recurrent apnoea group but significantly higher values than controls. Babies who are liable to develop recurrent apnoea can probably be identified at birth as their plasma AFP is exceptionally high. These conclusions refer only to babies who receive a maintenance dose of theophylline from the first week.