Maternal and fetal concentration of serum placental growth factor and their correlation to glycemic control and doppler study in diabetic and normal pregnancy

To determine whether maternal diabetes is associated with altered human placental growth factor [PIGF] level in serum of both mother and fetus and study he relation between PIGF and Doppler parameters, Prospective analytic comparative study. 30 normal pregnant female, 60 patients with gestational diabetes, 30 diabetic controlled and 30 diabetic uncontrolled. PIGF was measured in stored maternal serum samples taken in the 3[rd] trimester and cord sample of their babies after delivery by enzyme-linked immunosorbent assays [ELISA]. Diabetes during pregnancy was diagnosed with the 75-g oral glucose tolerance test and by applying world health organization criteria. Doppler velocimetry of umbilical vessels was evaluated for vascular impedance, in terms of pulsatility index and S/D ratio. Insignificant difference in serum maternal PIGF in both diabetic and non diabetic groups in the third trimester [p 0.139]. Cord serum PIGF was lower in diabetic controlled than uncontrolled group [p 0.023]. But there was significant negative correlation between maternal PIGF and cord serum PIGF in control [r -.537] and uncontrolled diabetic group [r -.384], p<0.05. Significant positive correlation between cord serum PIGF and S/D ratio was found [r .383], p<0.037. Significant negative correlation was found between PIGF in maternal serum and Doppler parameters in diabetic controlled group [r - 0.362], p value < 0.049 and in diabetic uncontrolled group [r = 0.500], p value < .005. FBS was positively correlated to cord serum PIGF in both controlled [r .603 and p value <0.001] and uncontrolled diabetic groups [r .934 and p value <0.001]. Maternal serum PIGF is similar in 3[rd] trimester in diabetic pregnancy and in control group. Serum cord PIGF was higher in uncontrolled than controlled diabetics. Significant negative correlation between maternal PIGF and cord serum PIGF in control and uncontrolled diabetic group. Rise in cord serum PIGF is related to chronic fetal hypoxia as evident by abnormal Doppler. Further studies are needed to confirm results