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Objective To investigate circulating levels of insulin‐like growth factor‐binding protein 1 (IGFBP‐1) and IGFBP‐3 in the mother and the fetus in pregnancies complicated by pre‐eclampsia, and the relationship between serum levels of IGFBPs and fetal birthweight. Design A prospective study over an 18 month period. Setting A tertiary care academic medical centre. Participants Sixty‐six pregnant women with pre‐eclampsia (35 cases of mild/moderate pre‐eclampsia and 31 cases of severe pre‐eclampsia) and 78 nonpra‐eclamptic pregnant women of matched gestational weeks and maternal ages. Main outcome measures Serum concentrations of IGFBP‐1 and IGFBP‐3 at the time of delivery. Results In pre‐eclampsia associated with intrauterine growth retardation (IUGR), maternal and cord serum IGFBP‐1 levels at the time of delivery were elevated. By contrast, circulating IGFBP‐3 levels in both the mother and the fetus were lower in pre‐eclampsia with IUGR than in nonpre‐eclamptic pregnancy. However, there was no difference in serum IGFBP‐1 and IGFBP‐3 levels between pre‐eclampsia without IUGR and nonpre‐eclamptic pregnancy in both the mother and the fetus. Conclusions In pre‐eclampsia, elevated concentrations of circulating IGFBP‐1 and decreased serum IGFBP‐3 levels were observed in both the mother and the fetus. However, these changes may simply reflect low birthweight in pre‐eclampsia.

From the present results, we conclude that insulin appears to be a regulator for circulating IGFBP-1 during pregnancy. The fetal growth may not be well reflected by maternal serum IGFBP-1 levels, nor by IGFBP-3. By contrast, cord serum IGFBP-1 from CS group without labor may preeminently reflect fetal weight. In additional, serum concentration of insulin and IGF-I in umbilical cord may also be good indicators to reflect the result of neonatal birthweight.

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