The Role of Maternal Factors, Postnatal Nutrition, Weight Gain, and Gender in Regulation of Serum IGF-I among Preterm Infants

Engström, Eva; Niklasson, Aimon; Wikland, Kerstin Albertsson; Ewald, Uwe; Hellström, Ann

doi:10.1203/01.pdr.0000155950.67503.bc

Cited by 79 publications

(74 citation statements)

References 47 publications

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“…Several studies have described positive correlations between circulatory concentrations of IGF-I and postnatal growth (12)(13)(14). We found that IGF-I had a positive modifying effect on change in weight SDS in both growth phases but did not find any corresponding effect of IGF-I for HC or length.…”

Section: Discussioncontrasting

confidence: 56%

“…Infusion of glucose but not amino acids regulates concentrations of IGF-I in fetal sheep (31). In preterm infants, both protein and energy intake have been demonstrated to have a positive effect on IGF-I concentrations (14,32). We found that a positive correlation between IGF-I and nutritional intake was restricted to the period beyond 30 GW.…”

Section: Discussionmentioning

confidence: 60%

“…Both IGF-I and IGF binding protein-3 (IGFBP-3) are related to early postnatal growth in preterm infants (12,13). Persisting low postnatal levels of IGF-I have been associated with impaired longitudinal weight gain, as well as retinopathy of prematurity in preterm infants (14,15).We hypothesized that the interaction between circulatory IGF-I concentrations, postnatal growth and nutrition would be different during the early growth restriction (GR) phase after birth compared with that during the later catch-up (CU) phase. This paper describes a prospective clinical study in very preterm infants, where weekly growth measurements and analyses of IGF-I with daily registrations of nutritional intake were related to growth during phases of GR and CU.…”

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confidence: 99%

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Influence of Insulin-Like Growth Factor I and Nutrition During Phases of Postnatal Growth in Very Preterm Infants

et al. 2011

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Pronounced growth restriction (GR) occurs after very preterm birth. The interaction between IGF-I, nutritional intake, and growth was evaluated prospectively in 64 infants with a mean (SD) GA of 25.7 (1.9) wk. Blood sampling of IGF-I and measurements of weight, length, and head circumference were performed weekly until discharge. Daily calculation of nutritional intake was performed. Standard deviation scores (SDSs) for growth parameters defined two growth phases: GR phase (birth until lowest SDS) and catch-up (CU) phase (lowest SDS until 35 gestational weeks). IGF-I concentrations during the first postnatal weeks were low and increased at 30 wk GA, irrespective of GA at birth, coinciding with initiation of CU growth. Concentrations of IGF-I were positively associated with change in weight SDS during the GR phase, p ϭ 0.001 and CU phase, p ϭ 0.004 -0.027. Protein and energy intake were not associated with change in SDS weight during the GR phase as opposed to the CU phase (p Ͻ 0.001, respectively). Nutritional intake did not correlate to concentrations of IGF-I before 30 wk GA. IGF-I is associated with growth at an earlier postnatal age than nutrient intake and the effect of nutrition on levels of IGF-I may be restricted to the period of established CU growth. T he maximum growth rate of the fetus is reached in the middle of pregnancy, where it is approximately three times higher than at term (1). Fetal growth rate is to a large extent determined by placental capacity of delivering nutrients to the fetus, whereas genetic influence seems to play a less important role. Placental function depends on the maternal nutritional state and the intrauterine endocrine environment. At preterm birth, the fetal-placental interaction is interrupted, which has an impact on continued extrauterine growth capacity. Postnatal growth retardation occurs almost inevitably after preterm birth and has been associated with decreased brain volumes and impaired neurodevelopmental outcome (2,3). Although attempts are made to optimize postnatal nutritional intakes in preterm infants, these are still commonly suboptimal according to intrauterine requirements (4). Increased postnatal nutritional intake has been shown to improve growth rate in very LBW infants (5), although a recent study could not demonstrate any apparent effect of hyperalimentation on subsequent postnatal growth in very preterm infants (6).IGF-I is an important fetal growth factor, which is essential for the developing brain (7). Concentrations of fetal IGF-I are closely related to placental transfer of glucose where fetal glucose increases insulin secretion, which in turn stimulates fetal IGF-I production (8). Fetal levels of IGF-I may also be regulated by an interaction at the feto-maternal placental interface (9). The disruption of placental nutrient supply after birth is followed by a rapid decrease in postnatal levels of IGF-I, suggesting a low endogenous production (10). While term infants restore their IGF-I levels within the first postnatal weeks, very prete...

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 60%

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confidence: 99%

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confidence: 99%

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Influence of Insulin-Like Growth Factor I and Nutrition During Phases of Postnatal Growth in Very Preterm Infants

et al. 2011

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“…The levels of hormones in these preterm infants will be influenced on the one hand by nutrition and on the other by the sensitivity within the GH axis. A GH resistant state persisting outside the neonatal period is recognized when gestation is interrupted prematurely (10).…”

Section: Table 1 Igf-i Igfbp-3 and Leptin Levels From Cord Blood Amentioning

confidence: 99%

The Contributions of Plasma IGF-I, IGFBP-3 and Leptin to Growth in Extremely Premature Infants During the First Two Years

et al. 2007

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ABSTRACT:We determined the contributions of IGF-I, IGFBP-3 and leptin to growth in -extremely premature infants over the first two years. Weight (Wt), crown-to heel length (CHL), plasma IGF-I, IGFBP-3 and leptin were measured in infants (gestation 24 -33 wk) at birth (n ϭ 54), expected date of delivery (EDD) and 6, 12 and 24 mo post-EDD (n ϭ 29). Area under the curve (AUC) for hormone levels was calculated over 4 periods: birth-EDD, EDD-200 d, EDD-350 d and EDD-700 d. IGFBP-3, but not IGF-I or leptin, on day 1 correlated with birth Wt SD scores (SDS) (r ϭ 0.46, p ϭ 0.002) and CHL SDS (r ϭ 0.41, p ϭ 0.01). Wt SDS at EDD correlated with AUC IGF-I, IGFBP-3 and leptin (birth-EDD), but leptin was the best predictor in multiple regression(r ϭ 0.65, p Ͻ 0.0001). Wt at EDD ϩ 700 d correlated with AUC leptin (EDD-700 d) (r ϭ 0.62, p ϭ 0.002). CHL SDS at EDD correlated with AUC IGFBP-3 and leptin (birth-EDD), but IGFBP-3 was the best predictor (r ϭ 0.55, p Ͻ 0.0001). CHL at EDD ϩ 700 d correlated with AUC IGF-I and IGFBP-3 (EDD-700 d), but IGFBP-3 was the best predictor (r ϭ 0.47, p ϭ 0.01). Wt and CHL at birth were associated with IGFBP-3 levels in these infants. Wt at EDD and EDD ϩ 700 d was predicted by concurrent leptin output while linear growth at EDD and EDD ϩ P reterm birth interrupts the physiologic fetal phase of growth when growth velocity is highest. Infants born at gestational age (GA) Ͻ32 wk have a different pattern of postnatal growth than those born moderately premature (GA Ն32 wk) or at term (1,2) and often exhibit growth failure, particularly over the first months of life. Signs of catch-up growth in weight and length can be observed by expected date of delivery (EDD) in infants born at GA 29 -31 wk but are not seen until after one year corrected age for more premature infants Ͻ29 wk gestation (2). Growth restriction, especially if associated with later catch-up, is of particular concern in such infants owing to the association with cardiovascular disease in adulthood (3). Life-long programming of the insulin like growth factor-I (IGF-I) system by intrauterine and postnatal hormonal and nutritional environment has been suggested to be a key mediator of this association (4,5).Nutrition is a key regulator of pre-and early postnatal somatic growth. Other factors thought to be important include IGF-I, its principal binding protein insulin like growth factor binding protein-3 (IGFBP-3) and leptin. Leger et al. (6) examined growth hormone (GH), IGF-I and IGFBP-3 levels in relation to growth over the 1 st 24 mo in 254 growth retarded children (birth weight Ͻ3 rd percentile; 81 born at GA 29 -37 wk) and 84 appropriate-for-GA (AGA) controls (40 born at GA 29 -37 wk). The growth retarded infants had high GH but low IGF-I and IGFBP-3 levels at birth. However, these biologic parameters were not predictive of later growth or of short stature at 2 y of age, and levels over 24 mo did not correlate with weight or length gain. A number of studies have characterized longitudinal growth in very preterm children (7-9) and...

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Longitudinal Postnatal Weight Measurements for the Prediction of Retinopathy of Prematurity

Wu¹

2010

Arch Ophthalmol

125

111

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The Role of Maternal Factors, Postnatal Nutrition, Weight Gain, and Gender in Regulation of Serum IGF-I among Preterm Infants

Cited by 79 publications

References 47 publications

Influence of Insulin-Like Growth Factor I and Nutrition During Phases of Postnatal Growth in Very Preterm Infants

Influence of Insulin-Like Growth Factor I and Nutrition During Phases of Postnatal Growth in Very Preterm Infants

The Contributions of Plasma IGF-I, IGFBP-3 and Leptin to Growth in Extremely Premature Infants During the First Two Years

Longitudinal Postnatal Weight Measurements for the Prediction of Retinopathy of Prematurity

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