Insulin-like growth factor-binding protein 1 and 7 concentrations are lower in obese pregnant women, women with gestational diabetes and their fetuses

Objective:to determine the effect of pre-existing maternal obesity and gestational diabetes mellitus (gdm) on the circulating levels of insulin growth factor-binding protein (igfbps) in cord and maternal plasma.study design:igfbp-1–7 levels were measured on maternal and cord plasma from women with normal glucose tolerance (ngt) (30 non-obese and 36 obese) and gdm (44 non-obese and 26 obese) at the time of term elective cesarean section.result:maternal plasma igfbp-1, igfbp-6 and igfbp-rp1 concentrations were significantly lower in ngt obese compared with ngt non-obese women and in non-obese gdm women compared with non-obese ngt women. in cord plasma, igfbp-1–3 and igfbp-rp1 concentrations were significantly lower in ngt obese compared with ngt non-obese women and in non-obese gdm women compared with non-obese ngt women. significant positive correlations were observed between maternal and cord plasma igfbp-1 and igfbp-rp1 levels and maternal insulin resistance. in cord plasma, significant positive correlations were observed between igfbp-1–3 and igfbp-rp1 levels and fetal insulin resistance. fetal birthweight was inversely correlated with maternal plasma igfbp-1 levels and cord plasma igfbp-1 and igfbp-2 levels. when corrected for maternal body mass index, the only significant relationship that still existed was between cord plasma igfbp-1 concentrations and fetal birthweight.conclusion:at the time of term cesarean section, pre-existing maternal obesity and gdm are associated with lower igfbp levels in maternal and cord plasma. alterations in circulating igf and igfbps may alter birthweight and/or neonatal adiposity. this may lead to alterations in optimal growth trajectory and lead to metabolic disorders later in life.