title: Elevated second-trimester amniotic fluid concentration of insulin-like growth factor binding protein-1 in fetal growth retardation.
abstract: OBJECTIVE
  The aim was to study the levels of amniotic fluid and maternal serum insulin-like growth factor binding protein-1 levels at 15 to 16 weeks' gestation with regard to fetal growth in the third trimester.
  
  
  METHODS
  Amniotic fluid (n = 148) and maternal serum (n = 129) levels of insulin-like growth factor binding protein-1 were prospectively measured.
  
  
  RESULTS
  Elevated amniotic fluid insulin-like growth factor binding protein-1 levels were related to fetal growth retardation. At a cutoff value of 3 multiples of the median a high-risk group comprising 16% of all pregnant women was identified. This group included 40% of all small-for-gestational age (birth weight < 10th percentile) and 55% of all very-small-for-gestational-age (birth weight < 5th percentile) infants. Maternal serum insulin-like growth factor binding protein-1 levels were not significantly elevated in these groups.
  
  
  CONCLUSIONS
  In most cases of intrauterine growth retardation the disturbance may exist before the condition is detectable by ultrasonography. An elevated amniotic fluid insulin-like growth factor binding protein-1 level may be an early sign.
authors.affiliation: Department of Obstetrics and Gynecology, Helsinki University Central Hospital.
authors.forename: T H
authors.initials: TH
authors.lastname: Hakala-Ala-Pietilä
authors.forename: R A
authors.initials: RA
authors.lastname: Koistinen
authors.forename: R K
authors.initials: RK
authors.lastname: Salonen
authors.forename: M T
authors.initials: MT
authors.lastname: Seppälä
mesh_terms: D000328:Adult; D000653:Amniotic Fluid / Q000378:metabolism*; D005260:Female; D005317:Fetal Growth Retardation / Q000378:metabolism*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011446:Prospective Studies
chemical_list: D007334:Insulin-Like Growth Factor I