A Longitudinal Analysis of Maternal Serum Insulin-Like Growth Factor I (IGF-I) and Total and Nonphosphorylated IGF-Binding Protein-1 in Human Pregnancies Complicated by Intrauterine Growth Restriction
S. Bhatia,
G. H. Faessen,
G. Carland,
R. L. Balise,
S. E. Gargosky,
M. Druzin,
Y. El-Sayed,
D. M. Wilson and
L. C. Giudice
Departments of Gynecology and Obstetrics (S.B., G.H.F., G.C., R.L.B., M.D., Y.E.-S., L.C.G.) and Pediatrics (D.M.W.), Stanford University Medical Center, Stanford, California 94305; Diagostics Systems Laboratories, Inc. (S.E.G.), Webster, Texas 77598; and Children’s Hospital Oakland (S.B.), Oakland, California 94609
Address all correspondence and requests for reprints to: Linda C. Giudice, Ph.D., M.D., Department of Gynecology and Obstetrics, Section of Reproductive Endocrinology and Infertility, Center for Research on Women’s Health and Reproductive Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Room HH 333, MC 5317, Stanford, California 94305-5317. E-mail: . giudice{at}stanford.edu
Abstract
In cord blood and late gestation maternal serum, IGF-I is positivelycorrelated with birth weight, whereas IGF-binding protein-1(IGFBP-1) is inversely correlated with birth weight. Our goalwas to determine whether maternal serum or amniotic fluid concentrationsof IGF-I, IGFBP-1, or nonphosphorylated IGFBP-1 (npIGFBP-1)in early gestation predict later fetal growth abnormalities.Maternal serum was collected prospectively across gestation(5–40 wk) from 749 pregnant subjects. Amniotic fluid wascollected after amniocentesis during wk 15–26 from 207subjects. We compared median serum concentrations of IGF-I,IGFBP-1, and npIGFBP-1 in 38 subjects who delivered growth-restrictedinfants with the control group of 236 subjects with normal weightinfants for each gestational age grouping, wk 5–12, 13–23,and 24–34. In the control group median IGF-I concentrationswere 14.8, 11, and 15.6 nmol/liter for wk 5–12, 13–23,and 24–34, respectively, compared with 13.7, 14.3, and10.6 nmol/liter in the intrauterine growth restriction (IUGR)group. Median IGFBP-1 concentrations were 8.5, 30.4, and 24.4nmol/liter, respectively, in controls, compared with 11.4, 28.6,and 25.5 nmol/liter in the IUGR group. Median npIGFBP-1 concentrationswere 6.9, 22, and 17.4 nmol/liter, respectively, in controls,compared with 5.0, 32.1, and 24.2 nmol/liter in the IUGR group.In the control group the median amniotic fluid IGFBP-1 levelwas 13,160 nmol/liter, and the median npIGFBP-1 level was 15,970nmol/liter; in the IUGR group these levels were 13,440 and 18,440nmol/liter, respectively. No clinically useful differences werefound between the IUGR and control groups. Our results do notsupport the use of maternal serum IGF-I or IGFBP-1 or amnioticfluid IGFBP-1 or npIGFBP-1 early in gestation to predict laterfetal growth restriction.
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