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Elevated second-trimester amniotic fluid concentration of insulin-like growth factor binding protein-1 in fetal
T H Hakala-Ala-Pietilä1, R A Koistinen, R K Salonen
1Department of Obstetrics and Gynecology, Helsinki University Central Hospital.
Objective:
The aim was to study the levels of amniotic fluid and maternal serum insulin-like growth factor binding protein-1 levels at 15 to 16 weeks' gestation with regard to fetal growth in the third trimester.
Study Design:
Amniotic fluid (n = 148) and maternal serum (n = 129) levels of insulin-like growth factor binding protein-1 were prospectively measured.
Results:
Elevated amniotic fluid insulin-like growth factor binding protein-1 levels were related to fetal growth retardation. At a cutoff value of 3 multiples of the median a high-risk group comprising 16% of all pregnant women was identified. This group included 40% of all small-for-gestational age (birth weight < 10th percentile) and 55% of all very-small-for-gestational-age (birth weight < 5th percentile) infants. Maternal serum insulin-like growth factor binding protein-1 levels were not significantly elevated in these groups.
Conclusion:
In most cases of intrauterine growth retardation the disturbance may exist before the condition is detectable by ultrasonography. An elevated amniotic fluid insulin-like growth factor binding protein-1 level may be an early sign.