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Changes in circulating level of IGF-I and IGF-binding protein-1 from the first to second trimester as predictors of preeclampsia

Department of Public Health, Norwegian University of Science and Technology, NO-7489 Trondheim, Norway¹ Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark² Department of Microbiology, Ullevål University Hospital, Oslo, Norway³ Department of Microbiology, Asker and Bærum Hospital, Bærum, Norway⁴ Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway and ⁵ Department of Obstetrics and Gynecology and Faculty of Medicine, Akershus University Hospital, University of Oslo, Lørenskog, Norway

(Correspondence should be addressed to L J Vatten; Email: lars.vatten{at}ntnu.no)

Objective: To assess whether circulating IGF-I and IGF-binding protein-1 (IGFBP-1) in the first and second trimester are associated with subsequent risk of preterm and term preeclampsia.

Methods: Nested case–control study within a cohort of 29 948 pregnant women. Cases were women, who later developed preeclampsia, and controls were randomly selected women, who did not develop preeclampsia. IGF-I and IGFBP-1 were measured with ELISA in maternal blood samples that were collected in the first and second trimesters. We assessed associations of IGF-I and IGFBP-1 concentrations with later development of preterm (before the 37th week of gestation) and term preeclampsia.

Results: An increase in IGF-I from the first to second trimester was associated with higher risk of preterm preeclampsia; the odds ratio (OR) for the highest compared with lowest quartile of increase was 4.9 (95% confidence interval, 1.1–21.8). Low concentrations of IGFBP-1, both in the first and in the second trimesters, were related to higher risk of term preeclampsia (OR 4.0, 95% confidence interval, 1.9–8.4) and moderately increased risk of preterm preeclampsia (OR 2.3, 95% confidence interval, 1.2–4.4).

Conclusion: The higher risk of preterm preeclampsia related to IGF-I increase may reflect placental disease, whereas low concentrations of IGFBP-1 associated with term preeclampsia may reflect maternal metabolic aberrations, indicating different etiologies in preeclampsia.