RESUMO
OBJECTIVE: To compare cord blood leptin concentrations between normal pregnancy, pregnancy induced hypertension (PIH), and gestational diabetes mellitus (GDM). DESIGN: Cross-sectional study. SETTING: Academic institutes and a tertiary care maternal hospital. METHOD: 48 newborns of normal pregnancies (N=18), pregnancy induced hypertension (N=16), and gestational diabetes mellitus (N=14) were studied. Cord blood samples were collected and newborn anthropometric indices recorded at delivery. Leptin concentrations were measured using an enzyme immunoassay. RESULTS: Cord blood leptin levels were significantly different between the 3 groups (Kruskal-Wallis ANOVA; P=0.0064), and the difference resulted mainly from higher levels in GDM than in PIH [geometric mean (95% CI) for GDM: 10.89 (6.30, 18.84) vs PIH: 3.49 (2.14, 5.69) ng/ml (Dunn's multiple comparison: P<0.01). This pattern persisted even when leptin levels were normalized to the ponderal index (Kruskal-Wallis ANOVA P=0.0035; Dunn's multiple comparison: P<0.01). Leptin levels significantly and positively correlated with the ponderal index in normal pregnancy (Spearman r=0.506, p<0.05) and with birth weight in PIH (r=0.5463, p<0.05). CONCLUSION: In GDM cord blood leptin levels are significantly higher, and a source other than fetal adipocytes appears to contribute to this.
Assuntos
Peso ao Nascer , Estatura , Estudos Transversais , Diabetes Gestacional/sangue , Feminino , Sangue Fetal/química , Humanos , Hipertensão Induzida pela Gravidez/sangue , Recém-Nascido , Leptina/sangue , Gravidez/sangueRESUMO
OBJECTIVES: To study the correlation of maternal and cord blood insulin like growth factor (IGF)-I and -II and IGF binding protein (IGFBP)-1 levels with birth weight and maternal anthropometric indices. DESIGN: Longitudinal prospective study. SETTING: Academic Institutions and a Tertiary Care Maternity Hospital. PARTICIPANTS: Women with uncomplicated singleton pregnancy (N = 35) and their newborns. MEASUREMENTS: Maternal weight, height, symphysiofundal height and serum levels of IGF-I, IGF-II, IGFBP-1 were measured thrice during the antenatal period, within 24 h of delivery and at 6 weeks and 6 months postpartum. Newborn anthropometric indices were recorded at birth, and at 6 weeks and 6 months of age. Cord blood levels of IGF-1, IGF-II, IGFBP-1, paternal height and weight, and placental weight measured. RESULTS: Maternal and cord blood IGF-I levels were lower than values reported for Caucasians. All newborns showed adequate growth at birth, and up to 6 months of age. Cord blood IGF-1 positively correlated with chest circumference (r = 0.4532, P = 0.0262), IGFBP-1, negatively with birth weight (r = -0.4024, P = 0.0461) and IGF-II had no effect. Cord blood IGF-I positively correlated with maternal levels at 28 +/- 2 (r = 0.4571, P = 0.0247) and 36 +/- 2 (r = 0.4291, P = 0.0364) weeks of amenorrhoea, whereas IGF-II and IGFBP-1 did not correlate with maternal values. Maternal IGF-I, IGF-II and IGFBP-1 did not correlate with newborn or maternal anthropometric indices. Placental weight correlated significantly with birth weight (r = 0.5299, P = 0.0348) and head circumference (r = 0.5031, P = 0.0470). CONCLUSIONS: Cord blood IGFBP-1 and placental weight appear to be determinants of birth weight variation even among appropriately grown for gestational age newborns.
Assuntos
Adulto , Antropometria , Peso ao Nascer , Feminino , Sangue Fetal , Nível de Saúde , Humanos , Recém-Nascido , Proteína 1 de Ligação a Fator de Crescimento Semelhante à Insulina/análise , Fator de Crescimento Insulin-Like I/análise , Fator de Crescimento Insulin-Like II/análise , Bem-Estar Materno , Gravidez , Resultado da Gravidez , Estudos ProspectivosRESUMO
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.