The role of serum insulin-like growth factor I (IGF-I) in neonatal outcome

Abstract

Aims: To determine the role of serum insulin-like growth factor I (IGF-I) in predicting the occurrence of septal hypertrophic cardiomyopathy in infants of mothers with diabetes. Methods/materials: In this prospective study, 100 pregnant women (50 with diabetes and 50 controls), matched for age and race, were studied. One intrapartum blood sample was taken at 28 weeks of gestation from both groups of mothers and another sample at delivery. All samples were analysed for maternal IGF-I by an enzyme linked immunosorbent assay method. A chest radiograph and an electrocardiogram were performed on the babies of the mothers with diabetes within the first 24 hours of life. An echocardiogram was performed in the first 3 days of life to look for septal hypertrophy and to measure the myocardial thickness. Results: In the six cases of neonatal septal hypertrophic cardiomyopathy, all the mothers had greatly raised IGF-I concentrations of more than 400 ng/ml at the time of delivery compared with a mean (SD) of 302 (25) ng/ml in control mothers. Conclusions: In the present study a crude analysis revealed that increased IGF-I concentrations correlate with neonatal septal hypertrophic cardiomyopathy.

Insulin-like growth factor (IGF)-I, IGF-binding protein (IGFBP)-1, and fibroblast growth factor (FGF) 21 serum levels in Chinese women with and without gestational diabetes

“…IGF-I also plays an important role during gestation in placental development and function [26]. Elevated levels of IGF-I have been associated with septal hypertrophic cardiomyopathy [27]. The results from this study confirmed previous observations in Caucasian women that IGF-I levels with or without adjustment for age and BMI are higher in GDM [28].…”

Cardiomyopathy and Diastolic Dysfunction in the Embryo and Neonate of a Type 1 Diabetic Mouse Model

“…Diabetic mothers who gave birth to infants (n ¼ 6) with neonatal septal hypertrophy had significantly (P < .01) higher IGF-1 levels than mean levels of control mothers (n ¼ 0 infants with septal hypertrophy) and also greater mean levels than that of all pooled diabetic mothers. 28 Evidence of diastolic impairment in the form of prolonged relaxation time of the myocardium prior to mitral valve opening was detected in our diabetic cohort during early to midgestation (Figure 1), which may imply increased passive stiffness of the myocardium. Passive stiffness is determined by 2 components: collagen-based stiffness of the extracellular matrix and titin-based stiffness of the microfilaments.…”

Freqüência cardíaca fetal e doplervelocimetria das artérias umbilicais entre a 18ª e a 20ª semana de gestação em pacientes com diabete melito pré-gestacional

“…Em gestações complicadas pelo diabete melito são descritas alterações do sistema cardiovascular fetal em que se verifi ca aumento da espessura das paredes ventriculares e do septo interventricular [13][14][15] e também a cardiomegalia 2,16,17 . A causa da taxa de crescimento cardíaco anormal não está clara, mas pode-se relatar diferença no grau de sensibilidade do miocárdio fetal a fatores de crescimento gerados pela mãe 17 , placenta ou feto em resposta à estimulação hiperglicemiante 18 .…”

“…A causa da taxa de crescimento cardíaco anormal não está clara, mas pode-se relatar diferença no grau de sensibilidade do miocárdio fetal a fatores de crescimento gerados pela mãe 17 , placenta ou feto em resposta à estimulação hiperglicemiante 18 . Especula-se que o acelerado crescimento cardíaco e a maturação funcional do sistema nervoso autônomo parassimpático cardíaco possam estar alterados quando comparado com o desenvolvimento de fetos normais, resultando em aumento na variabilidade da FCF 16,17 . Estudos ecocardiográfi cos demonstram alterações na função cardíaca fetal a partir da 20ª semana 18,19 de gestação, estando recomendado estudo do coração fetal ao redor da 24ª semana 20 .…”