Abstract
Background: Insulin and IGF-1 are considered as the main growth factors during fetal life. Both these factors were found accelerated in cord blood of LGA infants born to diabetic (IDM) and non-diabetic mothers. There is a few and not precise data about significance of IGF-2 in promoting of LGA. Design: to evaluate whether there is an association between occurrence of macrosomia and cord blood IGF-2 levels in infants of gestational diabetic and non-diabetic mothers. Material and Methods: The study material consisted of 74 LGA newborns (35 IDM and 39 non-IDM). 79 AGA neonates (37 IDM and 42 non-IDM) served as control groups. Gestational diabetes was recognized on basis of abnormal OGTT performed between 24–28 weeks of pregnancy. Macrosomia was defined as birthweight above 90th percentile. Gestational age (GA) in LGA groups were between 30 – 40 weeks while in AGA groups between 31 – 43 weeks. There was no signifant difference in mean GA between LGA and appropriate AGA group. The anthropometric parameters such as: birthweight, body length, head and chest circumference were measured at delivery and compared between the groups. Cord blood was sampled and IGF-2 levels were estimated using specific ELISA. Results: Mean birth weight (4318g v. 4097g), length (59,2 v. 57,7 cm) and chest circumference (36,1 v. 35,7 cm) in non-diabetic LGA were significantly higher than in diabetic LGA, but there were no significant difference in head circumference (36,3 v. 36,0 cm). Cord blood IGF-2 levels in both LGA groups was not significantly different (diabetic–383,3 versus 362,3 ng/ml in non-diabetic). A significant correlation (r=0,32; p <0,05) between birthweight and IGF-2 levels in both LGA groups but not in AGA groups was found. The significant correlation between head circumference and IGF-2 in diabetic (r= 0,37; p < 0,03) but not in non-diabetic LGA was also found. There was no significant correlation between cord blood IGF-2 levels and other anthropometric parameters in all groups. There was also no significant correlation between cord blood IGF-2 levels and gestational age. Conclusion: There is an association between occurrence of macrosomia and cord blood IGF-2 levels independently of maternal diabetes.
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