Insulin-like growth factors-I and -II and insulin-like growth factor binding protein-1 during normal pregnancy: pattern of secretion and correlation with other placental hormones.

OBJECTIVES: To describe pattern of secretion of insulin-like growth factor (IGF)-I, IGF-II, IGF binding protein (IGFBP)-1 and their correlation with each other and major placental hormones during normal pregnancy. DESIGN: Longitudinal study. SETTING: Academic Institutions and a Tertiary Care Maternity Hospital. PARTICIPANTS: Healthy women with singleton uncomplicated pregnancies (N = 35). MEASUREMENTS: Serum levels of IGF-I, IGF-II, IGFBP-1, chorionic gonadotrophin (HCG), placental lactogen (HPL), prolactin, oestradiol and progesterone were studied thrice during the antenatal period and within 24 h of delivery. RESULTS: IGF-I, IGFBP-1, HPL, prolactin, oestradiol and progesterone increased and HCG decreased significantly with advancing gestation (Repeated measures ANOVA: P < 0.01 to 0.0001). IGF-II levels were not significantly affected by period of gestation. Significant negative correlations (multiple regression analysis) were seen between IGFBP-1 and prolactin at 28 +/- 2 (P = 0.0226) and 36 +/- 2 (P = 0.0417) weeks of amenorrhoea (WOA) and between oestradiol and IGF-II at 36 +/- 2 WOA (P = 0.037). Prolactin and IGF-I at 14 +/- 2 WOA (P = 0.0225) and progesterone and IGFBP-1 at 28 +/- 2 WOA (P = 0.0216) correlated positively. CONCLUSIONS: Maternal IGF-I and IGFBP-1 but not IGF-II significantly increase as pregnancy advances. Components of the IGF system regulate or are affected by some of the placental hormones and the effects vary with the period of gestation.

Study of the impact of some hormones on brith weight

The aim of the present work was to study the relationship of neonatal leptin, insulin and human placental lactogen [hPL] to birth weight, gender difference and the maternal levels. Serum leptin, insulin and hPL were assessed in the cord blood of 60 neonates and the venous blood of their mothers. The neonates were classified according to their birth weight into 23 appropriate for gestational age [AGA] 20 large for gestational age [LGA] and 17 small for gestational age [SGA]. Data showed insignificant correlation of maternal hPL with insulin and leptin in both maternal and neonatal samples. Neonatal leptin, insulin and maternal hPL are important hormones that regulate the fetal growth and development. Insulin and leptin levels were significantly higher in the maternal blood than in the cord blood. Moreover, insignificant correlation was found regarding both hormones in the two compartments. Neonatal leptin and insulin showed no gender difference in neonates of different birth weights. The association of neonatal leptin or insulin with birth weight and the significant positive correlation between both are the determinative factors for the fetal birth weight

The influence of the smoke habit on maternal chronic gonadotropin (hCG) and placental lactogen (hPL) blood levels during the first trimester of pregnancy

Smoking habit is quite common in our society. It is well-known that this is harmful to adult health. We have worried about the effects of smoking upon fetuses of smoking mothers, suspecting that it could responsible for placental changes at the beginning of pregnancy. The influence of smoking on the maternal hCG and hPL blood levels was investigated, determining these hormones in blood samples during the first trimester of pregnancy. A comparison between smoking and nonsmoking groups showed significantly lower hCG blood levels in the smoking group. There was no difference of hPL values between the smoking and nonsmoking groups.

Influências das condiçöes maternas nos níveis sangüíneos da HCG e HPL no primeiro trimestre da gestaçäo / The influence of the maternal environment in the peripherical blood levels of GCH and LPH during first trimester of pregnancy

Com a finalidade de avaliar a influência do meio ambiente materno nos níveis sangüíneos dos hormônios gonadotrófico (HCG) e lactogêncio plancentário (HPL) no início da gestaçäo, foram estudadas 326 gestantes de primeiro trimestre. O HCG e o HPL foram dosados e padronizados para o dia 70 da gestaçäo para permitir a comparaçäo dos resultados. O meio ambiente materno foi avaliado através das dosagens de hemoglobina (Hb), hematócrito (Ht), volume corpuscular médio (VCM), contagem de glóbulos vermelhos (CGV), ferro (Fe), ferritina (Fer), capacidade total de ligaçäo do ferro (TIBC) e índice de massa corpórea (IMC). Concluiu-se que existe uma correlaçäo inversa estatisticamente significativa entre o IMC, Hb e Ht e os níveis sangüíneos maternos do HCG

Studies of the immediate postpartum diabetes remission and/or hypoglycemia after cesarean section in diabetic pregnancy

Five non-diabetic subjects, 5 gestational diabetics (GDM) treated with diet and 4 non-insulin dependent pregestational diabetics (NIDDM) treated with beef-pork insulin during their pregnancy, undergoing elective cesarean section (C-s), were given dextrose infusions without insulin for 7 hours (h) starting lh before the operation. Multiple blood samples were drawn up to 72 h after the C-s. The lowest glucose levels were observed at 3 3 or 6 h after surgery in all but two subjects. Plasma glucose below 2.75 mmol/l (49.5 mg/dl) were observed in 2 NIDDM patients. While in the non-diabetics and GDM the free (total) insulin and C-peptide values fell to very low levels, coinciding with the fall in plasma glucose, in the NIDDM there was a negative correlation between nadir glucose and free insulin levels with the progressive fall of antibody-bound insulin. In 3 out of NIDDM patients the antibodybound insulin fell to 57 to 73 per cent of the preoperative values. IGF-I/SmC, lower in the NIDDM, hGH immunoreactivity and hPL fell after C-s. The results suggest increased glucose utilization insulin-independent in the immediate postpartum in the non-diabetic pregnancy and GDM. However, in the NIDMM, in the presence of significant levels of free insulin, they tend to develop lower plasma glucose levels, sometimes hypoglycemia. Furthermore, lower IGF-I/Smc levels in the NIDDM in comparison to the non-diabetics and GDM would discard their role in the induction of hypoglycemia.

Serum Estriol, human placental lactogen and fetal abdominal circumference as predictors of intra uterine growth retardation in pre-eclampsia

Intra-uterine growth retardation [IUGR] is one of the major causes of neonatal morbidity and mortality which is frequently associated with pre-eclampsia. In a trial to search for an ideal method to predict IUGR, this study was performed on 30 cases of pre-eclampsia [20 mild cases and 10 severe cases]. These patients were subjected to single estimation of estriol [E3] human placental lactogen [HPL] and ultrasonographic measurment of abdominal circumference [AC] at 32-36 weeks of gestation and the patients were followed up till time of delivery. This study showed that AC is the most sensitive parameter in prediction of IUGR than serum HPL and serum estriol where its specificity was 91.7% and sensitivity was 100%. Furtherome, it is a simple, non-invasive method and could be used as a routine method for screening of IUGR in high-risk pregnancy especially in pre-eclampsia

Study on blood level of human placental lactogen in abnormal pregnancy.

The hormone human placental lactogen (HPL) was measured in 15 expectant mothers with pre-eclamptic toxaemia, 5 with postdated pregnancy and 2 mothers with intrauterine growth retardation (IUGR). These levels were compared with that of 43 expectant mothers without any complications. In preeclamptic toxaemia (PET), HPL showed higher or normal values but in severe cases of PET and in those with proteinuria, hormone level was depressed as compared to normal pregnancy. Also in younger mothers (22 years or less) with the complication, the hormone level was low, though no relation with parity was observed. In case of IUGR, the hormone level was within the normal range although one pregnancy ended in intra-uterine foetal death. Low level of the hormone was found in pregnancies ending in low birth weight babies and in postdated pregnancies with foetal postmaturity syndrome.

Human placental lactogen, estriol patern and the fetal growth

This study was done on 15 idiopathic intrauterine growth retardation [IUGR], 15 [IUGR] associated with hypertensive pregnancy. Determination of serum human placental lactogen [HPL] and estriol [E[3]] were performed serially in the third trimester. Serum levels of HPL [E[3]] were decreased in all [IUGR] pregnacies but more significant in [IUGR] with hypertensive pregnancy and also fetal and placental outcome in this cases showed significant decrease P < 0.02. In conclusion serial determination of serum E[3] and HPL in cases of IUGR and IUGR with hypertension was very important for early evaluation of this high risk groups, so proper therapy can be established

Evaluación hormonal del estado fetal: estriol total y somatomamotropina coriónica / Hormonal evaluation of fetal status: total estrioland chronic somatomanmotropin

Se presentan los resultados de 1,104 determinaciones de estriol total (E3) y 1,099 de somatomatropina coriónica (SMC) realizadas en forma seriada en el suero de embarazadas sanas (grupo testigo) y con gestaciones complicadas, en diferentes semanas del proceso reproductivo. Analizadas como grupo se obtuvieron significativamente menores valores en casos en que existió óbito fetal y toxemia, o cuando los recién nacidos fueron catalogados como hipotróficos; sin embargos, el valor pronóstico predicativo en el mejor de los casos fue de 39%. Los resultados se comentan en base a la fisiología de esas hormonas y a otros estudios previos, y se cuestiona la utilidad de solicitar esos análisis como parámetros de bienestar fetal

Serum human placental lactogen [hpl] in normal, toxaemic and diabetic pregnant women, during pregnancy and its relation to the outcome of pregnancy

Human placental lactogen [HPL] levels in serum were measured by radial immunodiffusion plates and immunoelectrophoresis in twenty normal, nineteen toxaemic and fourteen diabetic pregnant women, followed up during the first trimester [10-12 w.], the second trimester [20-22 w.], the 28th week, the 32nd week, the 36th week and two weeks after delivery. Serum human placental lactogen concentration showed progressive increase with the advance of pregnancy in all groups. It was not detected when measured two weeks after delivery in normal, toxaemic and diabetic pregnant women. Comparing the mean serum concentration in toxaernic pregnant patients with that in the normal group, the toxaemic group had lower mean serum hpl concentration throughout the period of pregnancy. On the other hand, diabetic pregnant women showed higher serum hpl concentration than normal pregnant women throughout the period of pregnancy. There was a positive correlation between infant weight, infant length and serum hpl levels at the 28th, 32nd weeks of gestation. Our results indicate that serial determination of serum hpl may he a valuable complement to other diagnostic aids in the supervisior of pregnancies, complicated by pre-eclampsia or diabetes

Human placental lactogen and estriol in high risk pregnancies

The plasma levels of hpl and estriol were measured in normal pregnants and complicated pregnacies using radio-immunoassay methods. It can be suggested that maternal plasma hpl and estriol values deviated from normal when the pregnancies complicated by conditions that diminish functional placental mass, low hpl and estriol values correlate to some extent with faetal outcome in complicated pregnancies. Elevated values in third trimester pregnancies may be helpful in identifying multiple gestations while hpl and estriol values are of little help in controlled diabetic where the major fetal risks are unrelated to chronic placental insufficiency. The clinical value of the. measurment of hpl and estriol is virtully identical. While the complication of both hpl estriol was found to be the best indicator of high risk pregnancies. Finaly from our results pregnancies complicated by IUGR, PET, hypertension, IUFD, post-maturity and diabetes mellitus where the fetus may be in jeopardy, hpl and estriol determination can be used by the obstetricions as an aid in deciding whether to allow a pregnancy to continue or to terminate it