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Serum insulin-like growth factor-I and insulin-like growth factor binding protein-3 in premature rupture of membranes
Mikko Loukovaara1, Riitta Koistinen, Tarja Kalme
1Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Finland. mikko.loukovaara@hus.fi
Insights
Circulating levels of insulin-like growth factor-I (IGF-I) and IGF binding protein-3 (IGFBP-3) do not change in women experiencing premature rupture of membranes (PROM) and preterm delivery. These factors do not appear to influence pregnancy maintenance in PROM cases, even with intrauterine infection.
Area of Science:
- Reproductive Endocrinology
- Maternal-Fetal Medicine
- Biochemistry
Background:
- Premature rupture of membranes (PROM) and preterm delivery are significant obstetric complications.
- Insulin-like growth factor-I (IGF-I) and its binding protein, IGFBP-3, are crucial for fetal growth and pregnancy maintenance.
- The role of IGF-I and IGFBP-3 in the context of PROM and preterm delivery requires further elucidation.
Purpose of the Study:
- To investigate the circulating levels of IGF-I and IGFBP-3 in pregnant women with PROM and preterm delivery.
- To determine if these levels differ compared to healthy, gestational age-matched controls.
- To assess the potential involvement of IGF-I and IGFBP-3 in pregnancy maintenance during PROM.
Main Methods:
- Serum samples were collected from 32 pregnant women diagnosed with PROM and 27 healthy controls.
- Levels of IGF-I and IGFBP-3 were quantified using established laboratory assays.
- Statistical analysis was performed using analysis of variance (ANOVA).
Main Results:
- Patients with PROM delivered preterm (mean gestational age 31.9 weeks), while controls delivered at term.
- Serum concentrations of IGF-I and IGFBP-3 were not statistically different between the PROM group and the control group.
- Subgroup analysis of PROM patients with evidence of intrauterine infection (elevated C-reactive protein) also showed no significant difference in IGF-I or IGFBP-3 levels compared to controls.
- Serial sampling in 22 PROM patients revealed no consistent changes in IGF-I or IGFBP-3 during a mean 9-day follow-up period.
Conclusions:
- Circulating IGF-I and IGFBP-3 levels do not appear to be significantly altered in patients with PROM and preterm delivery.
- These growth factors do not seem to play a critical role in the maintenance of pregnancy in the context of PROM, irrespective of intrauterine infection.
- The findings suggest that other mechanisms are primarily involved in the pathophysiology of PROM-related preterm delivery.
Background:
The aim of the study was to evaluate whether the circulating levels of insulin-like growth factor-I (IGF-I) and its major circulating binding protein, IGFBP-3, are affected in premature rupture of membranes (PROM) and preterm delivery.
Methods:
The levels of IGF-I and IGFBP-3 were measured in 32 pregnant women with PROM and in 27 healthy gestational age-matched pregnant women. Statistical analyzes were performed by analysis of variance.
Results:
All the patients with PROM had preterm delivery, at a gestational age of 31.9 +/- 0.4 weeks (mean +/- SEM). In the control subjects, pregnancy proceeded to term. In the PROM patients, the serum IGF-I and IGFBP-3 levels (289 +/- 21 ng/ml and 8248 +/- 407 ng/ml, respectively) were not statistically different from those in the control subjects (275 +/- 22 ng/ml and 7579 +/- 488 ng/ml). Seventeen patients with PROM showed a rise in serum C-reactive protein, indicating subclinical intrauterine infection. Also in this subgroup of patients the levels of serum IGF-I (281 +/- 27 ng/ml) and IGFBP-3 (9010 +/- 633 ng/ml) were not different from those in the control subjects. Before delivery, serial serum samples were available from 22 patients with PROM. No consistent changes in IGF-I or IGFBP-3 concentrations were seen during the mean follow-up period of 9 days.
Conclusions:
IGF-I and IGFBP-3 do not appear to play any significant role in the maintenance of pregnancy in PROM patients with preterm delivery, whether or not associated with emerging intrauterine infection.
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