Measurement of Amniotic Fluid Nitric Oxide and Fetal Plasma Growth Factor Levels in Pregnancies Complicated by Intrauterine Growth Restriction with Normal Uterine Artery Doppler Velocimetry / 대한주산의학회잡지

ABSTRACT

OBJECTIVE: Our purpose was to evaluate the relationship between amniotic fluid nitric oxide(NO) and fetal blood IGF-I, IGFBP-1, and cortisol in pregnancies complicated by intrauterine growth restriction(IUGR), but showing normal uterine artery doppler waveform. METHODS: From July 1999 to March 2000, 18 pregnant women with IUGR and 18 normal pregnancies were studied. Both group showed normal uterine artery doppler waveform. Amniotic fluid samples were collected to measure NO, and fetal blood samples were collected from umbilical vein to measure fetal growth factors. The definition used to identify cases of IUGR depended on three criteria clinical evidence of suboptimal growth, ultrasonographic evidence of deviation from an appropriate growth percentile, and individualized birth weight ratios <10th percentile. RESULTS: Overall median NO values in amniotic fluid were lower in IUGRs than in controls, but there was no statistical significance. However, IUGR newborns showed significantly lower(p<0.05) concentrations of IGF-I, and greater(p<0.05) concentrations of IGFBP-1 and cortisol than did controls. CONCLUSION: These result suggest that cord blood IGF-I, IGFBP-1, and cortisol, but not amniotic fluid NO may act major regulating factor in idiopathic IUGR without placental insufficiency.