title: Cord blood copeptin concentrations in fetal macrosomia.
abstract: OBJECTIVE
  Excessive fetal growth is associated with increased adiposity and reduced insulin sensitivity at birth. Copeptin, a surrogate marker of arginine vasopressin (AVP) secretion, is upregulated in states of hyperinsulinemia and is considered one of the mediators of insulin resistance. We aimed to investigate cord blood concentrations of copeptin (C-terminal fragment of AVP pro-hormone) in healthy large-for-gestational-age (LGA) infants at term.
  
  
  METHODS
  This prospective study was conducted on 30 LGA (n=30) and 20 appropriate-for-gestational-age (AGA, n=20) singleton full-term healthy infants. Cord blood copeptin and insulin concentrations were determined by ELISA and IRMA, respectively. Infants were classified as LGA or AGA, based on customized birth-weight standards adjusted for significant determinants of fetal growth.
  
  
  RESULTS
  Cord blood copeptin concentrations were similar in LGA cases, compared to AGA controls, after adjusting for delivery mode. However, in the LGA group, cord blood copeptin concentrations positively correlated with birth-weight (r=0.422, p=0.020). In the AGA group, cord blood copeptin concentrations were elevated in cases of vaginal delivery vs elective cesarean section (p=0.003). Cord blood insulin concentrations were higher in LGA cases, compared to AGA controls (p=0.036). No association was recorded between cord blood copeptin concentrations and maternal age, parity, gestational age or fetal gender in both groups.
  
  
  CONCLUSIONS
  Cord blood copeptin concentrations may not be up-regulated in non-distressed LGA infants. However, the positive correlation between cord blood copeptin concentrations and birth-weight in the LGA group may point to the documented association between AVP release and increased fat deposition. Vaginal delivery vs elective cesarean section is accompanied by a marked stress-related increase of cord blood copeptin concentrations.
authors.affiliation: Department of Neonatology, Athens University Medical School, Athens, Greece.
authors.forename: Despina D
authors.initials: DD
authors.lastname: Briana
authors.affiliation: Department of Neonatology, Athens University Medical School, Athens, Greece.
authors.forename: Stavroula
authors.initials: S
authors.lastname: Baka
authors.affiliation: Department of Neonatology, Athens University Medical School, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Boutsikou
authors.affiliation: Department of Neonatology, Athens University Medical School, Athens, Greece.
authors.forename: Theodora
authors.initials: T
authors.lastname: Boutsikou
authors.affiliation: Laboratory of Clinical Biochemistry-Molecular Diagnostics, 2nd Department of Pediatrics, Athens University Medical School, Athens, Greece.
authors.forename: Marieta
authors.initials: M
authors.lastname: Xagorari
authors.affiliation: Laboratory of Clinical Biochemistry-Molecular Diagnostics, 2nd Department of Pediatrics, Athens University Medical School, Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Gourgiotis
authors.affiliation: Department of Neonatology, Athens University Medical School, Athens, Greece. Electronic address: amalpu@aretaieio.uoa.gr.
authors.forename: Ariadne
authors.initials: A
authors.lastname: Malamitsi-Puchner
mesh_terms: D000328:Adult; D001724:Birth Weight; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D047109:Fetal Development; D005320:Fetal Macrosomia / Q000097:blood*; D006020:Glycopeptides / Q000097:blood*; D006801:Humans; D007231:Infant, Newborn; D007328:Insulin / Q000097:blood; D008297:Male; D009481:Neurophysins / Q000502:physiology; D011247:Pregnancy; D011446:Prospective Studies; D011498:Protein Precursors / Q000502:physiology; D014667:Vasopressins / Q000502:physiology
chemical_list: C438657:AVP protein, human; D006020:Glycopeptides; D007328:Insulin; D009481:Neurophysins; D011498:Protein Precursors; C048197:copeptins; D014667:Vasopressins
keywords: AVP; Copeptin; Cord blood; Fetal macrosomia; Insulin