Placental growth hormone and IGF‐I in a pregnant woman with <i>Pit‐1</i> deficiency

Verhaeghe, Johan; Bougoussa, M.; Herck, Erik Van; Zegher, Francis de; Hennen, Georges; Igout, Ahmed

doi:10.1046/j.1365-2265.2000.01044.x

Cited by 44 publications

(32 citation statements)

References 21 publications

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“…PGH was the major determinant of IGF-I concentrations, confirming the strong correlation between both variables in normal and IUGR pregnancies (3,4,10). We have reported that PGH and IGF-I concentrations were within the normal range and were highly correlated in a pregnant woman with absent GH secretion owing to pit-1-deficiency (35). The discrepant relation between BW and PGH (negative) vs. BW and IGF-I (positive) may be explained by the fact that insulin is a second important determinant of IGF-I levels.…”

Section: Discussionsupporting

confidence: 54%

“…PGH was measured by a twosite immunoradiometric assay, using rhPGH as the standard and two monoclonal antibodies. The detection limit is about 10 pmol/liter; within-and between-assay CV are 3.0 -5.5% and 5.0 -7.9%, respectively (33)(34)(35). IGF-I was measured by RIA after acid ethanol extraction, using rhIGF-I as the standard and a polyclonal antiserum raised in guinea pigs.…”

Section: Assaysmentioning

confidence: 99%

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Placental GH, IGF-I, IGF-Binding Protein-1, and Leptin during a Glucose Challenge Test in Pregnant Women: Relation with Maternal Body Weight, Glucose Tolerance, and Birth Weight

Verhaeghe

Pintiaux

Herck

et al. 2002

The Journal of Clinical Endocrinology & Metabolism

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The prediction of birth weight may be improved by the measurement of hormones or growth factors in the mother. We measured body weight (BW) and plasma levels of placental GH (PGH), IGF-I, IGF-binding protein-1 (IGFBP-1), and leptin at the time of the glucose challenge test (GCT) in 289 women, who were pregnant with a single fetus, between 24 and 29 wk gestational age (GA). Delivery occurred 12 ؎ 2 (mean ؎ SD) wk later.First, we examined which variables regulate these hormonal factors. Multiple regression showed that PGH concentrations were determined by GA at sampling and were negatively related to BW. IGF-I levels were mainly determined by PGH, and also by insulin, BW, and (negatively) age. IGFBP-1 concentrations were negatively determined by BW, insulin, and IGF-I. BW was also a powerful determinant of leptin levels, with insulin as a less robust determinant.Second, we examined the relation to glucose levels. PGH, IGF-I, and IGFBP-1 concentrations were not correlated with post-GCT glucose levels and were comparable in women with a normal or disturbed GCT (glucose >7.8 mmol/liter; n ‫؍‬ 72).Finally, we examined the relation with birth weight and placental weight. Birth weight, corrected for GA and stratified into percentile groups, and the ponderal index at birth were strongly related to maternal BW, but not to maternal PGH, IGF-I, or IGFBP-1 levels. Neither was maternal leptin related to birth weight, but leptin concentrations were slightly higher in women who delivered obese babies. Placental weight was not related to any of the hormonal factors.This prospective study indicates that the variation in circulating PGH, IGF-I, IGFBP-1, and leptin between 24 and 29 wk of pregnancy is strongly dependent on maternal BW, but is unrelated to glucose tolerance. In addition, the measurement of PGH, IGF-I, IGFBP-1, or leptin at the time of the GCT is not useful clinically to predict birth weight. (J Clin Endocrinol Metab 87: 2875-2882, 2002)

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Section: Discussionsupporting

confidence: 54%

Section: Assaysmentioning

confidence: 99%

Placental GH, IGF-I, IGF-Binding Protein-1, and Leptin during a Glucose Challenge Test in Pregnant Women: Relation with Maternal Body Weight, Glucose Tolerance, and Birth Weight

Verhaeghe

Pintiaux

Herck

et al. 2002

The Journal of Clinical Endocrinology & Metabolism

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“…In the first trimester, GH-N is still the predominant form of GH in maternal blood, does not cross placental barrier and is not essential to normal gestation development as observed in GH-deficient pregnant patients (35,36). During this period, rising estrogen levels would induce a state of GH resistance as reflected by a significant decline in circulating IGF-1, although a compensatory rise in GH-N levels has not been uniformly observed during this period (37,38).…”

Section: The Somatotrophic Axis During Normal Pregnancymentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Acromegaly and pregnancy: a contemporary review

Abucham

Bronstein

Rodrigues

2017

European Journal of Endocrinology

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Although fertility is frequently impaired in women with acromegaly, pregnancy is apparently becoming more common due to improvement in acromegaly treatment as well as in fertility therapy. As a result, several studies on pregnancy in patients with acromegaly have been published in recent years adding new and relevant information to the preexisting literature. Also, new GH assays with selective specificities and the knowledge of the expression of the various GH genes have allowed a better understanding of somatotrophic axis function during pregnancy. In this review, we show that pregnancy in women with acromegaly is generally safe, usually with tumoral and hormonal stability. Although the paucity of data limits evidence-based recommendations for preconception counseling and pregnancy surveillance, controlling tumor size and hormonal activity before pregnancy is highly recommended to ensure better outcomes, and surgical control should be attempted when feasible. Treatment interruption at pregnancy confirmation has also proven to be safe, as drugs are not formally allowed to be used during pregnancy. Drug exposure (somatostatin analogs) during early or whole pregnancy might increase the chance of a lower birth weight. Aggressive disease is uncommon and may urge individual decisions such as surgery or drug treatment during pregnancy or lactation.Correspondence should be addressed to J Abucham

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“…3 The description of progressive elevation of serum IGF1 in a pregnant woman with Pit-1 deficiency supports the hypothesis that placental GH is the prime regulator of maternal serum IGF1 during pregnancy. 4 GH deficiency is associated with decreased left ventricular ejection fraction at rest and on effort, decreased diastolic filling at rest, decreased myocardial wall thickness and decreased exercise duration and capacity. The severity of cardiac impairment correlates with the severity of GH deficiency.…”

Section: Discussionmentioning

confidence: 99%

Case report: Peripartum cardiomyopathy in a woman with hypopituitarism

Morton

Kannan

2005

BJOG

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A 12-year-old girl underwent transphenoidal partial resection and subsequent X-ray treatment to a 10-mm diameter craniopharyngioma in 1988. She developed panhypopituitarism within one year of treatment and was commenced on replacement treatment with thyroxine, cortisone acetate, oestrogen and progesterone. Growth hormone (GH) was not used as she had achieved satisfactory height. At age 25, she was documented to have GH deficiency with her serum insulin-like growth factor-I (IGF-1) being 10 nmol/L (normal 20-55 nmol/L). She conceived with in vitro fertilisation at age 28. At 22 weeks of gestation, cardiac investigations were performed because of a two-year history of intermittent palpitations. Echocardiography revealed normal left ventricular size and function with an ejection fraction of 60%, Holter monitoring disclosed frequent ventricular ectopics. At 35 weeks of gestation, she developed mild gestational hypertension that did not require any antihypertensive treatment. There were no features to suggest preeclampsia. She proceeded to have an elective caesarean section with spinal anaesthesia and intravenous hydrocortisone cover at 38 weeks of gestation. The caesarean section was performed because of maternal request. Her son weighed 3330 g. Twelve hours postpartum, she described progressive dyspnea. Her oxygen saturation was 83% with 8 L/minute oxygen via a Hudson mask, she was afebrile, pulse was 120 min and regular, blood pressure was 160/105 mm Hg and respiratory examination revealed bilateral crackles. Peripartum fluid balance was positive 1 L, no non-steroidal anti-inflammatory drugs were given. ECG was normal, chest X-ray was consistent with pulmonary oedema and ventilation-perfusion scanning was reported as a low probability for pulmonary embolism. Echocardiography revealed a severely dilated left ventricle (end-diastolic diameter 68 mm, end-diastolic volume 187 mL) with moderate global systolic dysfunction with ejection fraction of 37% consistent with peripartum cardiomyopathy (PPCM). No left ventricular thrombus was seen. Right ventricular systolic function appeared mildly reduced. There was moderate eccentric mitral regurgitation with the valve appearing structurally normal. The estimated right ventricular systolic pressure was 26 mmHg. She was treated with frusemide, perindopril and clexane and subsequently was commenced on warfarin and carvedilol. She did not lactate. GH replacement was considered but was deferred in view of progressive improvement in her left ventricular function on serial echocardiography and also because of the uncertain relationship between her longstanding GH deficiency and PPCM. At 12 months postpartum her ejection fraction had returned to normal. She is not contemplating further pregnancies. Long term GH replacement has not been considered because of cost issues as this treatment is not subsidised in Australia. DiscussionWe were able to identify outcome data for 83 pregnancies to mothers with GH deficiency and/or hypopituitarism from the published literature. On the basis of ...

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Placental growth hormone and IGF‐I in a pregnant woman with Pit‐1 deficiency

Cited by 44 publications

References 21 publications

Placental GH, IGF-I, IGF-Binding Protein-1, and Leptin during a Glucose Challenge Test in Pregnant Women: Relation with Maternal Body Weight, Glucose Tolerance, and Birth Weight

Placental GH, IGF-I, IGF-Binding Protein-1, and Leptin during a Glucose Challenge Test in Pregnant Women: Relation with Maternal Body Weight, Glucose Tolerance, and Birth Weight

MANAGEMENT OF ENDOCRINE DISEASE: Acromegaly and pregnancy: a contemporary review

Case report: Peripartum cardiomyopathy in a woman with hypopituitarism

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