Maternal and umbilical cord serum insulin-like growth factor-I: correlation with patterns of fetal growth and neonatal outcome in preeclampsia

ABSTRACT

The Aim of the study is to investigate the value of insulin-like growth factor-I in the maternal serum and cord blood as possible predictors of fetal growth and neonatal anthropometric parameters, and to correlate this with the severity of preeclampsia. A cohort cross sectional study. maternal serum and cord blood from 80 pregnant patients with preeclampsia [mild and severe] were investigated for IGF-I levels using ELISA technique and the results correlated to severity of preeclampsia, pattern of intra uterine fetal growth and neonatal outcome by Apgar score. A significant positive correlation was found between fetal and maternal IGF-I levels and birth weight and neonatal length and head circumference [P < 0.001]. Cord blood but not maternal IGF-I had a highly significant negative correlation with the severity of preeclampsia. Cord blood IGF-I was significantly higher in mild compared to severe preeclampsia cases and appropriate compared to small for gestational age [65.41 +/- 25.5 vs. 41.5 +/- 11.7 and 61.05 +/- 22.76 vs. 38.57 +/- 15.05 respectively P < 0.001]. Both fetal and maternal IGF-I are good predictors of fetal growth, and neonatal outcome by Apgar score in preeclampsia, although the predictability offered by maternal IGF-I may be less reflective with advancing gestational age. Fetal but not maternal IGF-I is a good marker for the severity of preeclampsia