title: Lower levels of placental growth hormone in early pregnancy in women with type 1 diabetes and large for gestational age infants.
abstract: OBJECTIVE
  To evaluate whether levels of placental growth hormone (GH) and Insulin-like Growth Factor-I (IGF-I) are associated with development of LGA infants in pregnant women with type 1 diabetes.
  
  
  METHODS
  Observational study of 103 consecutive pregnant women with long-term type 1 diabetes and median HbA1c 6.6% (range 4.9-10.5) (49 mmol/mol (30-91)) in early pregnancy. At 8, 14, 21, 27 and 33 weeks weight was recorded and blood was sampled for measurements of placental GH, IGF-I and HbA1c. LGA was defined as birth weight >90th percentile after adjustment for gender and gestational age.
  
  
  RESULTS
  Throughout pregnancy placental GH levels were similar in 51 (50%) women delivering LGA infants compared with the remaining women except at 8 weeks where placental GH levels were lower in women with LGA infants (1.1 ng/ml (0.1-4.3) vs. 1.7 (0.3-11.7), p = 0.04). IGF-I levels were similar in women with and without LGA infants (p=0.97). Gestational age at first blood sampling was similar in women with and without LGA infants (60 days (37-89) vs. 61.5 (42-94), p = 0.42). Placental GH levels at 14 weeks correlated negatively with weight gain in early pregnancy (r=-0.32, p=0.002). As predictors of LGA infants,multivariate logistic regression analysis identified placental GH levels at 8 weeks (OR 0.4 (95% CI: 0.2-0.9), p = 0.02), HbA1c at 33 weeks (3.6 (1.3-9.9), p = 0.01) and parity ≥1 (3.1 (1.3-7.5), p = 0.01) after adjustment for pre-pregnancy BMI.
  
  
  CONCLUSIONS
  Women delivering LGA infants had lower placental GH levels in early pregnancy. Growth factors and maternal weight gain in early pregnancy may be important for healthy fetal growth.
authors.affiliation: Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark; Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark; Steno Diabetes Center, Gentofte, Denmark. Electronic address: enel@dadlnet.dk.
authors.forename: Lene
authors.initials: L
authors.lastname: Ringholm
authors.affiliation: Department of Growth and Reproduction, Rigshospitalet, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
authors.forename: Anders
authors.initials: A
authors.lastname: Juul
authors.affiliation: Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Endocrinology Section, Department of Cardiology, Endocrinology and Nephrology, Nordsjællands Hospital Hillerød, Denmark.
authors.forename: Ulrik
authors.initials: U
authors.lastname: Pedersen-Bjergaard
authors.affiliation: Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Endocrinology Section, Department of Cardiology, Endocrinology and Nephrology, Nordsjællands Hospital Hillerød, Denmark.
authors.forename: Birger
authors.initials: B
authors.lastname: Thorsteinsson
authors.affiliation: Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Department of Obstetrics, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Damm
authors.affiliation: Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark; Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
authors.forename: Elisabeth R
authors.initials: ER
authors.lastname: Mathiesen
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism*; D005260:Female; D005320:Fetal Macrosomia / Q000378:metabolism*; D006442:Glycated Hemoglobin / Q000378:metabolism; D013006:Growth Hormone / Q000378:metabolism*; D006801:Humans; D007231:Infant, Newborn; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D016015:Logistic Models; D015999:Multivariate Analysis; D010920:Placenta / Q000378:metabolism*; D010926:Placental Hormones / Q000378:metabolism*; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000378:metabolism*; D015430:Weight Gain; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin; D013006:Growth Hormone; D007334:Insulin-Like Growth Factor I; D010926:Placental Hormones; C064980:GH2 protein, human; C583557:IGF1 protein, human; C517652:hemoglobin A1c protein, human
keywords: Gestational weight gain; Insulin-like Growth Factor-I; Large for gestational age; Placental growth hormone; Pregnancy; Type 1 diabetes