Vatten Lars J, Ødegård Rønnaug A, Nilsen Stein Tore, Salvesen Kjell A, Austgulen Rigmor
Department of Community Medicine and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.
Obstet Gynecol. 2002 Jan;99(1):85-90. doi: 10.1016/s0029-7844(01)01651-9.
To determine whether preeclampsia influences insulin-like growth factor-I (IGF-I), insulin-like growth factor binding protein-1 (IGFBP-1), and insulin-like growth factor binding protein-3 (IGFBP-3), independent of its effect on birth weight.
Cord blood was collected in 12,804 consecutive deliveries. We identified 258 preeclamptic pregnancies that were subclassified as mild or severe and early or late. For comparison, 609 control pregnancies were selected. Fetal growth was expressed as the ratio between observed and expected birth weight, with adjustment for gestational age at birth. IGF-I, IGFBP-1, and IGFBP-3 were measured in umbilical plasma. The contribution of preeclampsia and birth weight to each measured factor was assessed by multiple linear regression analyses.
Between mild preeclampsia and controls, there were no differences in IGF-I, IGFBP-1, and IGFBP-3. In severe and early onset preeclampsia, umbilical cord plasma IGF-I was approximately 50% lower, and IGFBP-1 was more than twice as high as in controls (both P <.01). At each birth weight level, IGF-I was lower and IGFBP-1 was higher in severe or early preeclampsia than among controls of similar weight. Birth weight and preeclampsia were, independent of each other, associated with IGF-I, whereas birth weight, but not preeclampsia, was associated with IGFBP-1, after adjustment for gestational age.
Fetal growth restriction caused by severe or early preeclampsia is associated with lower umbilical levels of IGF-I than low birth weight caused by other conditions. Preeclampsia may contribute to the observed IGF-I reduction, either as part of the underlying causes of preeclampsia, or as a consequence of the disease.
确定子痫前期是否会影响胰岛素样生长因子-I（IGF-I）、胰岛素样生长因子结合蛋白-1（IGFBP-1）和胰岛素样生长因子结合蛋白-3（IGFBP-3），而不考虑其对出生体重的影响。
收集了12804例连续分娩的脐带血。我们确定了258例子痫前期妊娠病例，并将其分为轻度或重度、早发型或晚发型。为作比较，选取了609例对照妊娠病例。胎儿生长情况以观察到的出生体重与预期出生体重之比表示，并对出生时的孕周进行了校正。在脐血浆中检测IGF-I、IGFBP-1和IGFBP-3。通过多元线性回归分析评估子痫前期和出生体重对每个检测因子的影响。
轻度子痫前期与对照组之间，IGF-I、IGFBP-1和IGFBP-3没有差异。在重度早发型子痫前期中，脐血浆IGF-I约低50%，IGFBP-1比对照组高出两倍多（均P<.01）。在每个出生体重水平上，重度或早发型子痫前期的IGF-I低于相似体重的对照组，而IGFBP-1则高于对照组。校正孕周后，出生体重和子痫前期相互独立地与IGF-I相关，而出生体重与IGFBP-1相关，子痫前期与IGFBP-1无关。
重度或早发型子痫前期所致的胎儿生长受限与脐血中IGF-I水平低于其他情况所致的低出生体重有关。子痫前期可能是导致观察到的IGF-I降低的原因之一，要么是子痫前期潜在病因的一部分，要么是该疾病的结果。
