Cord Blood Insulin Like Growth Factor-1 (IGF-1) and its Association to Fetal Hypertrophic Cardiomyopathy in Neonates of Diabetic Mothers
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- Category: Vol. 82, June 2014
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Cord Blood Insulin Like Growth Factor-1 (IGF-1) and its Association to Fetal Hypertrophic Cardiomyopathy in Neonates of Diabetic Mothers, HANAN F. MOHAMED and MAIESOON S. KHEDER
Abstract
Background: Fetal hypertrophic cardiomyopathy (HCM) is one of the well known disturbances and a well recognized comorbidity in neonates born to diabetic mothers, where intrauterine loss can occur in one third of affected fetuses and sometimes survivals can progress to overt congestive heart failure.
Insulin growth factor-1 (IGF-1) is the most important growth factor in utero and plays an important role in regulating embryonic, fetal and placental growth.
Aim of Work: Our aim was to evaluate whether there is an association between cord blood IGF-1 concentration in full term neonates and fetal HCM to explore the role of IGF-1 in the pathogenesis of septal HCM.
Material and Methods: This study was conducted on 50 neonates born to diabetic mothers and 20 control of non diabetic mothers at El Galaa Teaching Hospital.
Neonates were subjected to thorough clinical examination and echocardiographic evaluation. Cord blood IGF-1 and Maternal HbA1c were assessed.
Results: Our results revealed that 21 neonates born to diabetic mothers had septal HCM and that neonates of diabetic mothers had significant higher concentration of cord blood IGF-1 when compared to control (p=0.01). A statistically significant difference was also observed when neonates with septal HCM was compared to control and to neonates with non septal HCM (p<0.01,0.02 respectively). A significant positive correlation was found between IGF-1 levels and interventricular septum thickness (r=0.93, p<0.001). Neonates with septal HCM were infants of suboptimally controlled diabetic mothers with positive correlation between HbA1c and interventricular septum thickness (r=0.81, p<0.001).
Conclusion: There is association between IGF-1 and fetal HCM in neonates born to diabetic mothers and that may allow modulation of the activity of IGF-1 level to be a target for therapy to modify disease progression to allow better survival in patients with childhood presentation of HCM.