Fetal and maternal plasma insulin-like growth factors and binding proteins in pregnancies with appropriate or retarded fetal growth

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Abstract

A prospective observational study of 104 women was performed to study whether the insulin-like growth factor (IGF) system in pregnancy before labour is associated with reduced fetal growth. Fetal blood was obtained by cordocentesis for prenatal diagnosis or at elective caesarean delivery and a maternal sample was also obtained. IGF-1 and IGF-2 and their binding proteins -1 and -3 were measured by RIA. The 35 cases were smaller than -2S.D.s by ultrasound abdominal circumference and birthweight and were subdivided into fetal growth retardation (FGR, n = 20) and small for gestational age (SGA, n = 15) by Doppler velocimetry and neonatal outcome. Controls (n = 69) were normally grown.

Control maternal IGF-1 (r = 0.65, P < 0.0001) and IGFBP-3 (r = 0.46, P = 0.001) increased with advancing gestational age. In FGR cases, maternal IGF-1 was low (P = 0.0001) and IGFBP-1 was high (P = 0.03) and maternal IGF-2 was low in SGA (P = 0.005). In the SGA fetus, IGF-2 was low (P = 0.0009) and IGFBP-3 (P = 0.02) was high. In FGR, IGFBP-1 (P < 0.0001) and IGFBP-3 (P = 0.002) were both elevated.

These data do not support the hypothesis that fetal IGF-1 deficiency is a common cause of FGR. Elevated binding proteins may lead to a relative deficiency of free IGF but changes in binding proteins may be secondary to metabolic changes. In FGR, maternal IGF-1 was low with high binding proteins, so this system may be important in controlling placental transfer.

References (31)

  • S.L.S. Drop

    Report on the nomenclature of the IGF binding proteins

    Endocrinology

    (1992)
  • T.M. DeChiara et al.

    A growth-deficiency phenotype in heterozygous mice carrying an insulin-like growth factor II gene disrupted by targeting

    Nature

    (1990)
  • J.A.D. Spencer et al.

    Third trimester fetal growth and umbilical venous blood levels of IGF-1, IGFBP-1 and growth hormone at term

    Arch. Dis. Child

    (1995)
  • H.S. Wang et al.

    The concentration of insulin-like growth factor-1 and insulin-like growth factor binding protein-1 in human umbilical cord serum at delivery: relation to fetal weight

    J. Endocrinol.

    (1991)
  • M.L. Davenport et al.

    Regulation of serum insulin-like growth factor-1 (IGF-1) and IGF binding proteins during rat pregnancy

    Endocrinology

    (1990)
  • Cited by (0)

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