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Poster Session 2

Category: Ultrasound/Imaging

Poster Session 2

(399) Limited Diagnostic Value of Maternal Serum AFP Screening for Gastroschisis Detection

Wednesday, February 11, 2026

3:30 PM - 5:00 PM

Submitting Author and Presenting Author(s)

Abigail E. Rex (she/her/hers)

Medical Student
Baylor College of Medicine
Houst, Texas, United States

Coauthor(s)

Christian M. Parobek, MD, PhD

Fellow
Baylor College of Medicine
Houston, Texas, United States
MM

Morgan Motakef, BS

Medical Student
Baylor College of Medicine
Houston, Texas, United States
Brian A. Burnett, MD

Baylor College of Medicine
Houston, Texas, United States
KS

KC Sutherland

Baylor College of Medicine
Houston, Texas, United States
Rebecca M. Johnson, MS

Assistant Professor
Baylor College of Medicine
Houston, Texas, United States
Ahmed A. Nassr, MD, PhD

Associate Professor
Baylor College of Medicine
Baylor College of Medicine, Texas, United States

Objective:
With advances in prenatal ultrasound and the shift from serum aneuploidy screening to cell-free DNA testing, the role of maternal serum AFP (MSAFP) in detecting fetal body-wall defects is unclear. We evaluated the diagnostic utility of MSAFP screening for prenatal gastroschisis (GS) in a modern cohort.

Study Design:
We conducted an IRB-approved retrospective cohort study of prenatally diagnosed GS cases at a single fetal center, from 3/2012 to 3/2024. Maternal, fetal, and neonatal data were analyzed using bivariate statistics and linear regression to assess associations between MSAFP screening, diagnostic timing, and neonatal outcomes.

Results:
Among 149 prenatally-detected GS cases, 69 (46%) had MSAFP screening. MSAFP screening was not associated with earlier gestational age (GA) at GS suspicion or diagnosis (p=0.3 and p=0.4, respectively; Table 1). In contrast, early anatomy or NT ultrasound (US) led to significantly earlier diagnosis compared to MSAFP (median 14.5 vs. 19.1 weeks; p< 0.001). Among patients with timely prenatal care (n=136) but no early anatomy US, MSAFP screening was linked to a minor improvement in diagnostic timing (19.6 vs. 20.0 weeks; p=0.05). Regardless of MSAFP screening, those with early anatomy US had the earliest diagnoses of GS (Figure 1). Furthermore, MSAFP MoM values were not associated with neonatal morbidity composite (p=0.4).

Conclusion:
In the comparison of all GS cases, MSAFP screening was not associated with earlier diagnosis. In cases with timely prenatal care and no early anatomy ultrasound, MSAFP screening was associated with slightly earlier detection (~3 days). The level of MSAFP elevation was not predictive of adverse neonatal outcomes. These findings support prioritizing early ultrasound for prenatal diagnosis of gastroschisis and suggest that the diagnostic value of MSAFP is limited in current prenatal care.