Clinical significance of insulin-like growth factor in the development of fetal growth retardation syndrome
The authors made a prospective analysis of the courses of pregnancy and labor outcomes in 150 women with normal pregnancy and with fetal growth retardation syndrome (FGRS). The study established that in women with normal pregnancy higher concentrations of IF-I were found during the studied period of gestation, reaching the maximum values by the beginning of the 3rd trimester. In patients whose pregnancy was complicated by FGRS decreased IF-I levels – by 1.36–1.68 times as compared with normal pregnancy – were found as early as in the 2nd trimester. In FGRS grade 1 the dynamics of IF-I was, on the whole, similar to physiological pregnancy, which confirms preservation of compensatory abilities. In progressing placental insufficiency and FGRS grade 2 in the 3rd trimester the IF-I level somewhat increased but its average values were 1.4-fold less than in physiological pregnancy, which reflects insufficiency of compensatory mechanisms. In patients with FGRS grade 3 the most marked changes of IF-I production were found: its level progressively decreased beginning with the 29–30 week of gestation and then stabilized at lower levels than those in the 2nd trimester (2.2-fold lower than in physiological pregnancy), which might reflect a failure of compensatory abilities of the fetoplacental system. Therefore, the IF-I level in blood of pregnant women might be an early prognostic marker characterizing initial signs of disorders in the functioning of the «mother-placenta-fetus» system in FGRS. This would permit to administer drug therapy for this complication of pregnancy in due time, to select a rational obstetric tactics and improve perinatal outcomes.