title: Differential effects of low birthweight and intrauterine growth restriction on umbilical cord blood insulin-like growth factor concentrations.
abstract: OBJECTIVE
  Alterations in the growth hormone-insulin-like growth factor (IGF) axis have been considered as a causal factor for intrauterine growth restriction (IUGR) and for the increased risk of metabolic disease in later life. We compared members of the IGF axis in umbilical cord blood between IUGR neonates, small for gestational age without foetal restriction (SGA) and appropriate for gestational age (AGA) neonates.
  
  
  METHODS
  Prospective controlled multicenter study.
  
  
  METHODS
  Sixteen ultrasound-proven IUGR, 8 SGA and 40 AGA neonates.
  
  
  METHODS
  Concentrations of total IGF-I and total IGF-II by immunoassays, bioactive IGF by cell-based bioassay and IGFBP-I in mixed venous and arterial umbilical cord blood samples at birth. Auxological parameters at birth.
  
  
  RESULTS
  IGF-I concentrations in IUGR [17·7 μg/l (CI 13·8;21·6)] were clearly below those in AGA [48·3 μg/l (CI 43·7;52·9)] and SGA neonates [36·0 μg/l (CI 26·6;45·4)]. IGF-II levels were significantly reduced in IUGR [201·4 μg/l (CI 190·2;212·6)] compared to AGA neonates [231·2 μg/l (CI 220·6;241·9)]. A trend for lower IGF-II concentrations was observed in IUGR when compared to SGA neonates [232·0 μg/l (CI 207·2;256·8)]. These differences could not be explained by confounding. For IGFBP-1, a trend towards higher values in IUGR was observed.
  
  
  CONCLUSIONS
  Low IGF-I cord blood concentrations in hypotrophic neonates after IUGR might not only result from low birthweight per se, but also reflect prenatal placental environment. Alterations of the IGF axis could be in the causal pathway of IUGR and thus constitute a potential surrogate marker for IUGR in the assessment of foetal programming.
authors.affiliation: Department of Paediatrics and Adolescent Medicine, University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Tzschoppe
authors.affiliation: Institute of Social Paediatrics and Adolescent Medicine, University of Munich, Munich, Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Riedel
authors.affiliation: Institute of Social Paediatrics and Adolescent Medicine, University of Munich, Munich, Germany.
authors.forename: Rüdiger
authors.initials: R
authors.lastname: von Kries
authors.affiliation: Regional Centre for Social Paediatrics, Klinikum Konstanz, Konstanz, Germany.
authors.forename: Ellen
authors.initials: E
authors.lastname: Struwe
authors.affiliation: Department of Paediatrics and Adolescent Medicine, University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Rascher
authors.affiliation: Department of Paediatrics and Adolescent Medicine, University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Helmuth G
authors.initials: HG
authors.lastname: Dörr
authors.affiliation: Department of Obstetrics and Gynaecology, University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Matthias W
authors.initials: MW
authors.lastname: Beckmann
authors.affiliation: Department of Obstetrics and Gynaecology, Diakonische Dienste Hannover, Hannover, Germany.
authors.forename: Ralf L
authors.initials: RL
authors.lastname: Schild
authors.affiliation: Department of Obstetrics and Gynaecology, University of Aachen, Aachen, Germany.
authors.forename: Tamme W
authors.initials: TW
authors.lastname: Goecke
authors.affiliation: Medical Research Laboratory, Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.
authors.forename: Allan
authors.initials: A
authors.lastname: Flyvbjerg
authors.affiliation: Medical Research Laboratory, Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.
authors.forename: Jan
authors.initials: J
authors.lastname: Frystyk
authors.affiliation: Department of Paediatrics and Adolescent Medicine, University of Cologne, Cologne, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Dötsch
mesh_terms: D016022:Case-Control Studies; D005260:Female; D005312:Fetal Blood / Q000378:metabolism; D005317:Fetal Growth Retardation / Q000097:blood*; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000097:blood*; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000097:blood*; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D007335:Insulin-Like Growth Factor II / Q000378:metabolism*; D008297:Male; D010927:Placental Insufficiency / Q000097:blood*; D011247:Pregnancy; D011446:Prospective Studies
chemical_list: D018970:Insulin-Like Growth Factor Binding Protein 1; D007334:Insulin-Like Growth Factor I; D007335:Insulin-Like Growth Factor II