title: Maternal and fetal placental growth hormone and IGF axis in type 1 diabetic pregnancy.
abstract: OBJECTIVE
  Placental growth hormone (PGH) is a major growth hormone in pregnancy and acts with Insulin Like Growth Factor I (IGF-I) and Insulin Like Growth Hormone Binding Protein 3 (IGFBP3). The aim of this study was to investigate PGH, IGF-I and IGFBP3 in non-diabetic (ND) compared to Type 1 Diabetic (T1DM) pregnancies.
  
  
  METHODS
  This is a prospective study. Maternal samples were obtained from 25 ND and 25 T1DM mothers at 36 weeks gestation. Cord blood was obtained after delivery. PGH, IGF-I and IGFBP3 were measured using ELISA.
  
  
  RESULTS
  There was no difference in delivery type, gender of infants or birth weight between groups. In T1DM, maternal PGH significantly correlated with ultrasound estimated fetal weight (r = 0.4, p = 0.02), birth weight (r = 0.51, p<0.05) and birth weight centile (r = 0.41, p = 0.03) PGH did not correlate with HbA1c. Maternal IGF-I was lower in T1DM (p = 0.03). Maternal and fetal serum IGFBP3 was higher in T1DM. Maternal third trimester T1DM serum had a significant band at 16 kD on western blot, which was not present in ND.
  
  
  CONCLUSIONS
  Maternal T1DM PGH correlated with both antenatal fetal weight and birth weight, suggesting a significant role for PGH in growth in diabetic pregnancy. IGFBP3 is significantly increased in maternal and fetal serum in T1DM pregnancies compared to ND controls, which was explained by increased proteolysis in maternal but not fetal serum. These results suggest that the normal PGH-IGF-I-IGFBP3 axis in pregnancy is abnormal in T1DM pregnancies, which are at higher risk of macrosomia.
authors.affiliation: UCD Obstetrics and Gynaecology, School of Medicine and Medical Science, University College Dublin, National Maternity Hospital, Dublin, Ireland.
authors.forename: Mary F
authors.initials: MF
authors.lastname: Higgins
authors.forename: Noirin E
authors.initials: NE
authors.lastname: Russell
authors.forename: Paul A
authors.initials: PA
authors.lastname: Crossey
authors.forename: Kristine C
authors.initials: KC
authors.lastname: Nyhan
authors.forename: Derek P
authors.initials: DP
authors.lastname: Brazil
authors.forename: Fionnuala M
authors.initials: FM
authors.lastname: McAuliffe
mesh_terms: D000328:Adult; D001724:Birth Weight; D015153:Blotting, Western; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D005260:Female; D005333:Fetus / Q000378:metabolism*; D013006:Growth Hormone / Q000097:blood*; D006801:Humans; D015151:Immunoblotting; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood*; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D010920:Placenta / Q000378:metabolism; D010926:Placental Hormones / Q000097:blood*; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000097:blood*; D016216:Ultrasonography, Prenatal; D055815:Young Adult
chemical_list: C064980:GH2 protein, human; D018972:Insulin-Like Growth Factor Binding Protein 3; D010926:Placental Hormones; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone