Chellakooty M, Vangsgaard K, Larsen T, Scheike T, Falck-Larsen J, Legarth J, Andersson A M, Main K M, Skakkebaek N E, Juul A
University Department of Growth and Reproduction, Rigshospitalet, Copenhagen, Denmark.
J Clin Endocrinol Metab. 2004 Jan;89(1):384-91. doi: 10.1210/jc.2003-030282.
The aim of the study was 1) to evaluate the association of maternal serum levels of placental GH and IGF-I with fetal growth, and 2) to establish reference data for placental GH, IGF-I, and IGF-binding protein-3 (IGFBP-3) in normal pregnancies based on longitudinal measurements. A prospective longitudinal study of 89 normal pregnant women was conducted. The women had, on the average, seven blood samples taken and three ultrasound examinations performed. All had normal umbilical artery pulsatility indexes during pregnancy and gave birth to singletons between 37 and 42 wk gestation with birth weights above -2 SD. Placental GH levels were detectable in all samples from as early as 5 wk gestation and increased significantly throughout pregnancy to approximately 37 wk when peak levels of 22 ng/ml (range, 4.64-69.22 ng/ml) were reached. Subsequently, placental GH levels decreased until birth. The change in placental GH during 24.5-37.5 wk gestation was positively associated with fetal growth rate (P = 0.027) and birth weight (P = 0.027). Gestational age at peak placental GH values (P = 0.007) was associated with pregnancy length. A positive association between the change in placental GH and the change in IGF-I levels throughout gestation was found in a multivariate analysis (r(2) = 0.42; P < 0.001). There was no association between placental GH and IGFBP-3 levels. The change in IGF-I throughout gestation (P = 0.039), but not placental GH, was significantly positively associated with placental weight at birth. We found a significant association between placental GH and fetal growth. In addition, we found a highly significant association between the increase in placental GH and the increase in IGF-I. The gestational age at peak placental GH levels was associated with pregnancy length.
1）评估孕妇血清中胎盘生长激素（GH）和胰岛素样生长因子-I（IGF-I）水平与胎儿生长的相关性；2）基于纵向测量，建立正常妊娠中胎盘GH、IGF-I和胰岛素样生长因子结合蛋白-3（IGFBP-3）的参考数据。对89名正常孕妇进行了一项前瞻性纵向研究。这些孕妇平均采集了7份血样并进行了3次超声检查。所有孕妇在孕期脐动脉搏动指数均正常，且均在妊娠37至42周之间分娩单胎，出生体重高于-2标准差。早在妊娠5周时，所有样本中均可检测到胎盘GH水平，且在整个孕期显著升高，至约37周时达到峰值水平22 ng/ml（范围为4.64 - 69.22 ng/ml）。随后，胎盘GH水平下降直至分娩。妊娠24.5至37.5周期间胎盘GH的变化与胎儿生长速率呈正相关（P = 0.027），与出生体重也呈正相关（P = 0.027）。胎盘GH峰值时的孕周（P = 0.007）与妊娠时长相关。多因素分析发现，整个孕期胎盘GH的变化与IGF-I水平的变化呈正相关（r² = 0.42；P < 0.001）。胎盘GH与IGFBP-3水平之间无相关性。整个孕期IGF-I的变化（P = 0.039）与出生时胎盘重量显著正相关，而胎盘GH与出生时胎盘重量无显著相关性。我们发现胎盘GH与胎儿生长之间存在显著相关性。此外，我们还发现胎盘GH的升高与IGF-I的升高之间存在高度显著的相关性。胎盘GH峰值时的孕周与妊娠时长相关。
