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Lower levels of placental growth hormone in early pregnancy in women with type 1 diabetes and large for gestational age infants.
Growth Horm IGF Res. 2015 Dec; 25(6):312-5.GH

Abstract

OBJECTIVE

To evaluate whether levels of placental growth hormone (GH) and Insulin-like Growth Factor-I (IGF-I) are associated with development of LGA infants in pregnant women with type 1 diabetes.

DESIGN

Observational study of 103 consecutive pregnant women with long-term type 1 diabetes and median HbA1c 6.6% (range 4.9-10.5) (49 mmol/mol (30-91)) in early pregnancy. At 8, 14, 21, 27 and 33 weeks weight was recorded and blood was sampled for measurements of placental GH, IGF-I and HbA1c. LGA was defined as birth weight >90th percentile after adjustment for gender and gestational age.

RESULTS

Throughout pregnancy placental GH levels were similar in 51 (50%) women delivering LGA infants compared with the remaining women except at 8 weeks where placental GH levels were lower in women with LGA infants (1.1 ng/ml (0.1-4.3) vs. 1.7 (0.3-11.7), p = 0.04). IGF-I levels were similar in women with and without LGA infants (p=0.97). Gestational age at first blood sampling was similar in women with and without LGA infants (60 days (37-89) vs. 61.5 (42-94), p = 0.42). Placental GH levels at 14 weeks correlated negatively with weight gain in early pregnancy (r=-0.32, p=0.002). As predictors of LGA infants,multivariate logistic regression analysis identified placental GH levels at 8 weeks (OR 0.4 (95% CI: 0.2-0.9), p = 0.02), HbA1c at 33 weeks (3.6 (1.3-9.9), p = 0.01) and parity ≥1 (3.1 (1.3-7.5), p = 0.01) after adjustment for pre-pregnancy BMI.

CONCLUSIONS

Women delivering LGA infants had lower placental GH levels in early pregnancy. Growth factors and maternal weight gain in early pregnancy may be important for healthy fetal growth.

Authors+Show Affiliations

Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark; Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark; Steno Diabetes Center, Gentofte, Denmark. Electronic address: enel@dadlnet.dk.Department of Growth and Reproduction, Rigshospitalet, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Endocrinology Section, Department of Cardiology, Endocrinology and Nephrology, Nordsjællands Hospital Hillerød, Denmark.Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Endocrinology Section, Department of Cardiology, Endocrinology and Nephrology, Nordsjællands Hospital Hillerød, Denmark.Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Department of Obstetrics, Rigshospitalet, Copenhagen, Denmark.Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark; Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26589570

Citation

Ringholm, Lene, et al. "Lower Levels of Placental Growth Hormone in Early Pregnancy in Women With Type 1 Diabetes and Large for Gestational Age Infants." Growth Hormone & IGF Research : Official Journal of the Growth Hormone Research Society and the International IGF Research Society, vol. 25, no. 6, 2015, pp. 312-5.
Ringholm L, Juul A, Pedersen-Bjergaard U, et al. Lower levels of placental growth hormone in early pregnancy in women with type 1 diabetes and large for gestational age infants. Growth Horm IGF Res. 2015;25(6):312-5.
Ringholm, L., Juul, A., Pedersen-Bjergaard, U., Thorsteinsson, B., Damm, P., & Mathiesen, E. R. (2015). Lower levels of placental growth hormone in early pregnancy in women with type 1 diabetes and large for gestational age infants. Growth Hormone & IGF Research : Official Journal of the Growth Hormone Research Society and the International IGF Research Society, 25(6), 312-5. https://doi.org/10.1016/j.ghir.2015.11.002
Ringholm L, et al. Lower Levels of Placental Growth Hormone in Early Pregnancy in Women With Type 1 Diabetes and Large for Gestational Age Infants. Growth Horm IGF Res. 2015;25(6):312-5. PubMed PMID: 26589570.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lower levels of placental growth hormone in early pregnancy in women with type 1 diabetes and large for gestational age infants. AU - Ringholm,Lene, AU - Juul,Anders, AU - Pedersen-Bjergaard,Ulrik, AU - Thorsteinsson,Birger, AU - Damm,Peter, AU - Mathiesen,Elisabeth R, Y1 - 2015/11/11/ PY - 2015/07/21/received PY - 2015/10/13/revised PY - 2015/11/08/accepted PY - 2015/11/22/entrez PY - 2015/11/22/pubmed PY - 2016/9/15/medline KW - Gestational weight gain KW - Insulin-like Growth Factor-I KW - Large for gestational age KW - Placental growth hormone KW - Pregnancy KW - Type 1 diabetes SP - 312 EP - 5 JF - Growth hormone & IGF research : official journal of the Growth Hormone Research Society and the International IGF Research Society JO - Growth Horm. IGF Res. VL - 25 IS - 6 N2 - OBJECTIVE: To evaluate whether levels of placental growth hormone (GH) and Insulin-like Growth Factor-I (IGF-I) are associated with development of LGA infants in pregnant women with type 1 diabetes. DESIGN: Observational study of 103 consecutive pregnant women with long-term type 1 diabetes and median HbA1c 6.6% (range 4.9-10.5) (49 mmol/mol (30-91)) in early pregnancy. At 8, 14, 21, 27 and 33 weeks weight was recorded and blood was sampled for measurements of placental GH, IGF-I and HbA1c. LGA was defined as birth weight >90th percentile after adjustment for gender and gestational age. RESULTS: Throughout pregnancy placental GH levels were similar in 51 (50%) women delivering LGA infants compared with the remaining women except at 8 weeks where placental GH levels were lower in women with LGA infants (1.1 ng/ml (0.1-4.3) vs. 1.7 (0.3-11.7), p = 0.04). IGF-I levels were similar in women with and without LGA infants (p=0.97). Gestational age at first blood sampling was similar in women with and without LGA infants (60 days (37-89) vs. 61.5 (42-94), p = 0.42). Placental GH levels at 14 weeks correlated negatively with weight gain in early pregnancy (r=-0.32, p=0.002). As predictors of LGA infants,multivariate logistic regression analysis identified placental GH levels at 8 weeks (OR 0.4 (95% CI: 0.2-0.9), p = 0.02), HbA1c at 33 weeks (3.6 (1.3-9.9), p = 0.01) and parity ≥1 (3.1 (1.3-7.5), p = 0.01) after adjustment for pre-pregnancy BMI. CONCLUSIONS: Women delivering LGA infants had lower placental GH levels in early pregnancy. Growth factors and maternal weight gain in early pregnancy may be important for healthy fetal growth. SN - 1532-2238 UR - https://www.unboundmedicine.com/medline/citation/26589570/Lower_levels_of_placental_growth_hormone_in_early_pregnancy_in_women_with_type_1_diabetes_and_large_for_gestational_age_infants_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1096-6374(15)30034-4 DB - PRIME DP - Unbound Medicine ER -