Am J Perinatol 2019; 36(14): 1442-1452 DOI: 10.1055/s-0038-1677472
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Early Postnatal IGF-1 and IGFBP-1 Blood Levels in Extremely Preterm Infants: Relationships with Indicators of Placental Insufficiency and with Systemic Inflammation
Alan Leviton
1
Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
,
Elizabeth N. Allred
1
Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
,
Raina N. Fichorova
2
Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
,
Deborah K. VanderVeen
3
Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
,
T. Michael O'Shea
4
Department of Pediatrics, University of North Carolina, Chapel Hill, North Carolina
,
Karl Kuban
5
Division of Neurology, Department of Pediatrics, Boston Medical Center, Boston University, Boston, Massachusetts
,
Olaf Dammann
6
Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts
7
Perinatal Neuropidemiology Unit, Hannover Medical School, Hannover, Germany
,
for the ELGAN Study Investigators› Author AffiliationsFunding This study was supported by the National Institute of Neurological Disorders and Stroke (5U01NS040069–05; 2R01NS040069–06A2), The National Eye Institute (1-R01-EY021820–01), the National Institute of Child Health and Human Development (5P30HD018655–34), and the Office of the NIH Director (1UG3OD023348–01).
Objective To evaluate to what extent indicators of placenta insufficiency are associated with low concentrations of insulin-like growth factor 1 (IGF-1) and IGF-1–binding protein-1 (IGFBP-1) in neonatal blood, and to what extent the concentrations of these growth factors are associated with concentrations of proteins with inflammatory, neurotrophic, or angiogenic properties.
Study Design Using multiplex immunoassays, we measured the concentrations of IGF-1 and IGFBP-1, as well as 25 other proteins in blood spots collected weekly from ≥ 880 infants born before the 28th week of gestation, and sought correlates of concentrations in the top and bottom quartiles for gestational age and day the specimen was collected.
Results Medically indicated delivery and severe fetal growth restriction (sFGR) were associated with low concentrations of IGF-1 on the first postnatal day and with high concentrations of IGFBP-1 on almost all days. Elevated concentrations of IGF-1 and IGFBP-1 were accompanied by elevated concentrations of many other proteins with inflammatory, neurotrophic, or angiogenic properties.
Conclusion Disorders associated with impaired placenta implantation and sFGR appear to account for a relative paucity of IGF-1 on the first postnatal day. Elevated concentrations of IGF-1 and especially IGFBP-1 were associated with same-day elevated concentrations of inflammatory, neurotrophic, and angiogenic proteins.
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