孕妇血清IGF-1、IGF-2、IGFBP-3水平与正常胎儿生长的相关性

 目的 探讨孕妇血清胰岛素样生长因子1(insulin like growth factor 1,IGF-1)、IGF-2、IGF结合蛋白3(IGF binding protein 3,IGFBP-3)与正常胎儿生长的关系。 方法 选择2010年1月至2011年5月于上海市浦东新区人民医院产前检查并分娩正常体重儿的初产妇66例,分为妊娠16～18周、妊娠26～28周、妊娠37～40周3个阶段进行纵向观察,放射免疫法测定孕妇各阶段血清中IGF-1、IGF-2、IGFBP-3水平并进行对比分析。 结果 孕期母血IGF-1水平随着孕周增加明显上升,其中IGF 1水平在妊娠37～40周高于妊娠26～28周,妊娠26～28周高于妊娠16～18周,差异均有显著统计学意义(P均＜0.01)。孕期母血IGF 2水平随孕周增加无明显改变,妊娠3阶段差异无统计学意义(P＞0.05)。母血IGFBP 3水平妊娠37～40周高于妊娠26～28周及妊娠16～18周期,差异有统计学意义(P＜0.05),而妊娠26～28周与妊娠16～18周无显著差异。妊娠16～18周、26～28周和37～40周3阶段母血IGF-1、IGF-2、IGFBP-3水平与正常新生儿出生体重无显著相关性。 结论 孕妇血清IGF-1、IGFBP-3水平与正常胎儿生长密切相关,IGF-1可作为临床评价不同阶段正常胎儿生长的指标,而IGFBP-3更多地反映了妊娠中晚期正常胎儿的生长。

The correlation between maternal serum IGF-1,IGF-2,IGFBP-3 levels and normal fetal growth

Objective To investigate the effects of insulin like growth factor-1 (IGF-1),IGF-2,IGF binding proteins-3 (IGFBP-3) in maternal serum on fetal growth.Methods Sixty-six cases of primiparas with prenatal check up and delivery of normal birth weight infant from Jan.,2010 to May.,2011 were selected in this study.Maternal serum at 16 18,26 28 and 37 40 gestational weeks were obtained for measuring IGF-1、IGF-2、IGFBP-3 by enzyme linked immunosorbent assay (ELISA).Results There was marked increase in maternal serum IGF-1 during pregnancy,of which serum IGF-1 at 37-40 gestational weeks was significantly higher than the level at 26-28 weeks,and 26 28 weeks significantly higher than 16-18 weeks (P<0.001).There was no significant change in maternal serum IGF-2 at early,mid and full term stage of pregnancy (P>0.05).Maternal serum IGFBF-3 at 37-40 gestational weeks was significantly higher than the level at 26-28 and 16 18 weeks (P<0.05),but no difference between 26-28 weeks and 16-18 weeks (P>0.05).No significant correlation between maternal serum IGF-1,IGF-2,IGFBP-3 and birth weight of newborn infants was observed at different gestational stages during pregnancy.Conclusions IGF-1 and IGFBP-3 might be related to fetal growth,of which IGF-1 could be a clinical biomarker for evaluation of normal fetal growth at different gestational stages,while IGFBP-3 would reflect more normal fetal growth at mid and late gestational stages.