The Correlation Between IGF-1 Levels In Maternal Blood And Umbilical Cord Blood And Neonatal Neurobehavioral Score In GDM

Objectives 1 To analysis the correlation between IGF-1 levels and insulin resistance in gestational diabetes mellitus by detecting of serum IGF-1,fasting blood glucose,fasting insulin of pregnant women and cord blood IGF-1 levels;2 To analysis the relationship between neonatal NABA score and IGF-1,HOMA-IR and other factors in GDM,and then to explore the influencing factors of gestational diabetes mellitus neonatal neurobehavioral development;Methods 47 cases were randomly chosen as GDM group,who were diagnosed as gestational diabetes mellitus and received prenatal examination and delivered in North China University of Science and Technology Affiliated Hospital from October.2015 to April.2016,normal pregnant women in our hospital were selected 55 cases as control group at the same time.The fasting cubital vein blood of two pregnant women were collected before delivery,umbilical cord blood was collected from two groups of pregnant women during delivery.Enzyme linked immunosorbent assay(ELISA)was used to detect the level of IGF-1 in the serum of pregnant women and cord blood,fasting glucose and fasting insulin were repectively measured by glucose oxidase method and electrochemiluminescence immunoassay,The development of neonatal nervous system was evaluated according to neonatal neurobehavioral test(NBNA)score,the degree of insulin resistance was measured by the insulin resistance index(HOMA-IR).Sorting data,measurement data using t test,count data using Chi square test,Pearson correlation analysis was used to judge the relation between the two indicators,the relationship between a dependent variable and multiple independent variable using multiple linear regression analysis method.Results 1 The serum levels of IGF-1 in group of GDM women(176.03±15.98pg/ml)was lower than that of control group(190.14±33.34pg/ml),and the difference was statistically significant(t=-2.786,P=0.007);Cord blood levels of IGF-1 in group of GDM(181.85±16.49pg/ml)was higher than that in control group(169.34±18.92pg/ml),the difference was statistically significant(t=3.531,P=0.001);GDM maternal serum levels of IGF-1 was negatively correlated with fetal cord blood IGF-1(r=-0.323,P=0.027).2 The fasting blood glucose,fasting insulin and insulin resistance index in GDM pregnant woman were significantly higher than those in the control group,and the difference was statistically significant(P<0.01),the maternal blood levels of IGF-1 and HOMA-IR in GDM group was negatively correlated(r=-0.446,P=0.002),and the cord blood levels of IGF-1 and HOMA-IR in GDM group was positively correlated(r=0.586,P=0.000).3The neonatal NABA score of GDM group(36.13±1.63score)was lower than that of control group(37.49±1.48score),the difference was statistically significant(t=-4.403,P=0.000);4 The neonatal NABA score of GDM and the fasting blood glucose,fasting insulin,HOMA-IR and fetal cord blood IGF-1 was negatively correlated,and was positively correlated with serum levels of IGF-1 in pregnant women;Multiple linear regression analysis available,Maternal blood and cord blood IGF-1 are closely related to neonatal NABA score,the abnormal level of serum IGF-1 of mother and fetus may affect gestational diabetes neonatal neurobehavioral development situation.Conclusions 1 The serum levels of IGF-1 in pregnant women with gestational diabetes mellitus was significantly decreased,while the levels of IGF-1 in umbilical cord blood was significantly increased.there was a negative correlation between the two.2 In pregnant women with gestational diabetes mellitus,the low level of maternal blood IGF-1 and the high level of umbilical cord blood levels of IGF-1 were associated with GDM insulin resistance,indicating that the IGF-1 may be involved in the insulin resistance of GDM.3 Neonatal behavioral neurological score was significantly lower in pregnant women with gestational diabetes mellitus,mainly manifested in the behavior ability,active muscle tension and passive muscle tension;the decrease of maternal serum levels of IGF-1 and the increase of umbilical cord blood levels of IGF-1 are closely related to the abnormal neonatal neurobehavioral development of gestational diabetes mellitus.