scholarly journals MON-283 IGF-1 Levels During Normal Pregnancy

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Guillermo Javier Thomas ◽  
Agustina Peverini ◽  
Fernando Smithuis ◽  
Dolores Fabbro ◽  
Julieta Tkatch ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Reference Values ◽  
Metabolic Diseases ◽  
Clinical Endocrinology ◽  
Normal Pregnancy ◽  
Specific Reference ◽  
Serum Samples ◽  
Estrogen Regulation ◽  
Growth Hormone Action

Abstract Pregnancy is associated with a physiological GH excess, where maternal pituitary GH is suppressed by effect of placental GH on the hepatic receptor, increasing IGF-1 serum levels1. However, it is also described that estrogens and progesterone are responsible for reduction in IGF-1 by direct hepatic action through the inhibition of the JAK-STAT pathway that results in GH resistance, being more clear at the beginning of pregnancy.2 Acromegaly is a rare disorder in which GH axis is deregulated and IGF-1 is the most reliable biochemical marker for diagnosis and monitoring. It is know that secondary hypogonadism associated with these pathology decreases fertility rates. Nonetheless, improvement of acromegaly treatment and greater access to assisted reproductive technology increase pregnancy rates in this population. The follow-up of pregnant acromegalic women acquires relevance for the comorbidities of this association and depends on the adequate interpretation of the IGF-1 values. Then, due to changes in concentration and action of IGF-1 during pregnancy3, it is important that each laboratory establish their specific reference values. For that reason we analyzed serum samples from 80 healthy pregnant women living in the Metropolitan Area of Buenos Aires (AMBA): 22 were in the 1st trimester (1T), 29 in the 2nd (2T) and 29 in the 3rd (3T). All women were between 30 and 40 years old, had no endocrinopathies or metabolic diseases. Serum IGF-1 was measured by Immulite 2000 Siemens, and Prism8 GraphPad was used for statistical analysis, calculating ranges for each trimester defined as 2,5 and 97,5 percentiles. Ranges obtained were: 64,5-165,0 ng/ml, 78,9-201,0 ng/ml and 96,1-344,0 ng/ml for 1T, 2T and 3T, respectively. Significant differences were observed between 3T and the other trimesters (1T and 2T). We also compared these ranges with our reference values from healthy non-pregnant women in the same age, and found that 3T has significantly higher values ​​of IGF-1 (55,8-188,4 ng/ml vs. 96,1-344,0 ng/ml respectively). In conclusion, IGF-1 levels during the first two trimesters of pregnancy remain within the normal range, and there is a significant increase during the third trimester. Given that IGF-1 plays an essential role during pregnancy, it is important to report ranges in healthy pregnant women to contribute in the follow-up of patients with acromegaly who get pregnant. Although our results are in agree with the available literature, it is necessary to increase the number of healthy pregnant women to establish reference values of IGF-1. 1Frankenne et al (1988). The physiology of growth hormones in pregnant women and partial characterization of the placental GH variant. Journal of Clinical Endocrinology and Metabolism 66:1171-1180 2Leung et al (2004). Estrogen regulation of growth hormone action. Endocrine Reviews 25:693-72 3Muhammad et al (2017). Pregnancy and acromegaly. Pituitary 20:179-184

scholarly journals Early pregnancy reference intervals; 29 serum analytes from 4 to 12 weeks’ gestation in naturally conceived and uncomplicated pregnancies resulting in live births

2019 ◽  
Vol 57 (12) ◽  
pp. 1956-1967 ◽  
Author(s):  
Jesper Friis Petersen ◽  
Lennart J. Friis-Hansen ◽  
Andreas Kryger Jensen ◽  
Anders Nyboe Andersen ◽  
Ellen C.L. Løkkegaard
Keyword(s):  
Pregnant Women ◽  
Early Pregnancy ◽  
Clinical Chemistry ◽  
Clinical Care ◽  
Local Population ◽  
First Trimester ◽  
Reference Intervals ◽  
Specific Reference ◽  
Cancer Antigen 125 ◽  
Serum Samples

Abstract Background Pregnancy introduces major physiological changes that also alter biochemical analytes. Maternal and perinatal health can be optimized by early intervention and therefore, pregnancy-specific reference intervals (RIs) for the local population are warranted. While the second and third trimester-specific changes are well described, the first trimester is less well characterized. We therefore wanted to facilitate early detection of abnormalities by generating first trimester reference values for 29 common analytes. Methods In a prospective early pregnancy (PEP) cohort (2016–2017), 203 pregnant women were recruited from 4 to 8 weeks’ gestation. Consecutive blood samples were drawn every 2 weeks until an ongoing second trimester pregnancy (n = 164) or a miscarriage (n = 39) occurred. After exclusion of women with complicated pregnancies or deliveries (n = 42), 122 women were included. The serum samples collected at <6, 6–8, 8–10, 10–12 and >12 weeks’ gestation were analyzed for 29 common analytes. Subsequently the RIs were calculated according to the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) recommendations (2.5–97.5th percentiles) and compared with the conventional RIs for non-pregnant women. Results Human chorionic gonadotropin (hCG), progesterone (P4), estradiol (E2), pregnancy-associated plasma protein A (PAPP-A), cancer antigen 125 (CA125), thyroid stimulating hormone (TSH), creatinine (CREA) and albumin (ALB) showed an early pregnancy-dependent change compared with conventional limits. For ALB the change was seen at 5.5 weeks’ gestation. Conclusions We report gestational age-specific RIs available from the early part of the first trimester applicable to everyday clinical care of pregnant women. Well-known alterations of RIs seen in later trimesters are also observed in the first.

Gestational age-specific reference intervals for 15 biochemical measurands during normal pregnancy in China

2017 ◽  
Vol 55 (4) ◽  
pp. 446-452 ◽  
Author(s):  
Yanpeng Dai ◽  
Junjie Liu ◽  
Enwu Yuan ◽  
Yushan Li ◽  
Quanxian Wang ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Gestational Age ◽  
Parametric Method ◽  
First Trimester ◽  
Normal Pregnancy ◽  
Reference Intervals ◽  
Specific Reference ◽  
Gamma Glutamyl Transpeptidase ◽  
Cross Sectional ◽  
Laboratory Results

Aims Physiological changes that occur during pregnancy can influence biochemical parameters. Therefore, using reference intervals based on specimens from non-pregnant women to interpret laboratory results during pregnancy may be inappropriate. This study aimed to establish the essential reference intervals for a range of analytes during pregnancy. Methods A cross-sectional study was performed in 13,656 healthy pregnant and 2634 non-pregnant women. Fifteen biochemical measurands relating to renal and hepatic function were analysed using an Olympus AU5400 analyzer (Olympus, Tokyo, Japan). All the laboratory results were checked for outliers using Dixon’s test. Reference intervals were established using a non-parametric method. Results Alanine aminotransferase, aspartate aminotransferase, albumin, cholinesterase, creatinine, direct bilirubin, gamma-glutamyl transpeptidase, total bilirubin, total bile acid and total protein showed a decrease during the whole gestational period, while alkaline phosphatase and uric acid increased. Urea nitrogen, β2-microglobulin and cystatin-C fell significantly during the first trimester and then remained relatively stable until third trimester. Reference intervals of all the measurands during normal pregnancy have been established. Conclusions The reference intervals established here can be adopted in other clinical laboratories after appropriate validation. We verified the importance, for some measurands, of partitioning by gestational age when establishing reference intervals during pregnancy.

scholarly journals Long term follow up of biomarkers of podocyte damage and renal function in patients with and without preeclampsia

2018 ◽  
Vol 40 (4) ◽  
pp. 339-343
Author(s):  
Ylbe Palacios de Franco ◽  
Karina Velazquez ◽  
Natalia Segovia ◽  
Gladys Sandoval ◽  
Estefania Gauto ◽  
...  
Keyword(s):  
Renal Function ◽  
Serum Creatinine ◽  
Post Partum ◽  
Normal Pregnancy ◽  
Serum Samples ◽  
Protein Excretion ◽  
Long Term Follow Up ◽  
Urine And Serum

ABSTRACT Introduction: preeclampsia can be associated with future renal disease. Objectives: To measure changes in renal function overtime in patients with preeclampsia. Methods: urine and serum samples from eleven patients with preeclampsia and eight patients with a normal pregnancy were obtained during pregnancy, postpartum, and 3 years after delivery. Urine podocalyxin, protein, and serum creatinine were measured. Results: after 3 years, there were no significant differences in urinary podocalyxin in patients with or without preeclampsia: 4.34 ng/mg [2.69, 8.99] vs. 7.66 ng/mg [2.35, 13], p = 0.77. The same applied to urinary protein excretion: 81.5 mg/g [60.6, 105.5] vs. 43.2 mg/g [20.9, 139.3] p = 0.23. Serum creatinine was 0.86 mg/dL [0.7, 0.9] vs. 0.8 mg/dL [0.68, 1] p = 0.74 in those with and without preeclampsia. In normal patients, urinary podocalyxin decreased from 54.4 ng/mg [34.2, 76.9] during pregnancy to 7.66 ng/mg [2.35, 13] three years after pregnancy, p = 0.01. Proteinuria decreased from 123.5 mg/g [65.9, 194.8] to 43.2 mg/g [20.9, 139.3], p = 0.12. In preeclampsia patients, urinary podocalyxin decreased from 97.5 ng/mg [64.9, 318.4] during pregnancy to 37.1 ng/mg within one week post-partum [21.3, 100.4] p = 0.05 and 4.34 ng/mg [2.69, 8.99] three years after, p = 0.003. Proteinuria was 757.2 mg/g [268.4, 5031.7] during pregnancy vs. 757.2 mg/g [288.2, 2917] postpartum, p = 0.09 vs. 81.5 mg/g [60.6, 105.5] three years later, p = 0.01. Two patients still had proteinuria after 3 years. Conclusions: in preeclampsia patients, postpartum urinary podocalyxin decreased before proteinuria. After three years, serum creatinine, urinary podocalyxin, and protein tended to normalize, although some patients still had proteinuria.

Gestational age-specific reference values of placental thickness in normal pregnant women

2019 ◽  
Vol 59 (7) ◽  
pp. 718-729 ◽  
Author(s):  
E. Keshavarz ◽  
M. Motevasselian ◽  
B. Amirnazeri ◽  
S. Bahramzadeh ◽  
H. Mohammadkhani ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Reference Values ◽  
Gestational Age ◽  
Specific Reference ◽  
Placental Thickness

scholarly journals First trimester thyroid function in pregnant women residing in Saint Petersburg (Russia): reference values and risk of gestational diabetes

2018 ◽  
Vol 21 (1) ◽  
pp. 34-41
Author(s):  
Polina V. Popova ◽  
Ekaterina S. Shilova ◽  
Alexandra S. Tkachuk ◽  
Alexandra V. Dronova ◽  
Anna D. Anopova ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Pregnant Women ◽  
Reference Values ◽  
Subclinical Hypothyroidism ◽  
Reference Interval ◽  
First Trimester ◽  
Specific Reference ◽  
Thyroid Status ◽  
Saint Petersburg ◽  
Increased Risk

Background. Subclinical hypothyroidism during pregnancy and gestational diabetes mellitus (GDM) is known to be associated with maternal and child morbidity. The concept of subclinical dysfunction of the thyroid gland in pregnant women depends on the population-specific and trimester-specific reference values so fixed universal cutoff concentrations for thyroid-stimulating hormone (TSH) that were recommended earlier now are put under the question. Population-specific and trimester-specific reference values have not been defined for pregnant women residing in Saint Petersburg. The data concerning the association of maternal thyroid status with GDM development are controversial. Aims. The aim of the study was to determine the reference values of TSH and free thyroxin (fT4) in the first trimester of pregnancy in women living in St. Petersburg, and to assess the relationship between thyroid status and the risk of subsequent development of GDM. Materials and methods. The levels of TSH, fT4 and thyroid peroxidase antibodies (TPO-Ab) were analyzed in 503 pregnant women before the 14th week of gestation. The women underwent oral glucose tolerance test (OGTT) at 2428 weeks to find out those with GDM. The association between thyroid function, thyroid autoimmunity and the risk of GDM we estimated. Results. The reference values for TSH were 0.07 4.40 mU /L, and for fT4 11.7 20.3 pmol/L. The prevalence of subclinical hypothyroidism in the 503 pregnant women was 16.9% according to the diagnostic criteria of TSH 2.5 mIU / L and 3.8% using our calculated reference interval. Hypothyroxinemia was registered in 5,3% using reference values recommended by diagnostic tests manufacturer and in 2,8% according to our calculated reference interval for fT4. GDM was diagnosed in 23% of women. Logistic regression analysis showed associations of hypothyroxinemia and TPO-Ab-positivity with the increased risk of GDM that remained significant after adjustments on age and body mass index (BMI) [adjusted OR (95% CI) = 7.39 (1.2742.93) for hypothyroxinemia, p=0.026; and adjusted OR (95% CI) = 2.02 (1.014.04) for TPO-Ab-positivity, p=0.047). Conclusions. Reference intervals for first trimester TSH and fT4 have been established for pregnant women living in St. Petersburg. Hypothyroxinemia and TPO-Ab-positivity were associated with the increased risk of GDM.

scholarly journals Predictive values of multiple serum biomarkers in women with suspected preeclampsia: a prospective study

2020 ◽  
Author(s):  
Jing Wang ◽  
Honghai Hu ◽  
Xiaowei Liu ◽  
Shenglong Zhao ◽  
Yuanyuan Zheng ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Prospective Cohort ◽  
Serum Markers ◽  
Serum Biomarkers ◽  
Clinical Implementation ◽  
Operating Characteristics ◽  
Serum Samples ◽  
Multisystem Disorder ◽  
Predictive Values

Abstract Background: Preeclampsia is a common obstetric multisystem disorder causing maternal and fetal morbidity and mortality; it’s been shown that the prediction improves preeclampsia outcomes in pregnancy. However, the current serum biomarkers had low clinical application values and still lack validation studies. Here we aimed to evaluate the preeclampsia prediction values of a series of serum biomarkers in Chinese pregnant women of > 20 weeks of gestation. Methods: Singleton pregnant women with preeclampsia-related clinical and/or laboratory presentations were recruited and had blood drawn at their first visits. The prospective cohort was further divided into preeclampsia-positive and preeclampsia-negative groups based on the follow-up results. The following markers were tested using the collected serum samples: soluble fms-like tyrosine kinase-1 (sFlt-1); placental growth factor (PlGF); thrombomodulin (TM); tissue plasminogen activator inhibitor complex (tPAI-C); compliment factors C1q, B, and H; glycosylated fibronectin (GlyFn); pregnancy-associated plasma protein-A2 (PAPP-A2); blood urea nitrogen (BUN); creatinine (Cre); uric acid (UA); and cystatin C (Cysc). Results: A total of 196 women with suspected preeclampsia were recruited with follow-up medical records. Twenty-five percent (n=49) of the recruited subjects developed preeclampsia before delivery, and 75% remained preeclampsia-negative (n=147). The serum levels of sFlt-1, BUN, Cre, UA, Cysc and PAPP-A2 were significantly elevated, and the PlGF level was significantly decreased in the preeclampsia-positive patients. In the receiver operating characteristics (ROC) analyses, the area under the curves were listed in the order of decreasing values: 0.73 (UA), 0.67 (sFlt-1/PlGF), 0.66 (Cysc), 0.65 (GlyFn/PlGF), 0.64 (PAPP-A2/PlGF), 0.63 (BUN), 0.63 (Cre), and 0.60 (PAPP-A2). With the cut-off values obtained from the ROC analyses, the positive predictive values of these serum markers were between 33.1% and 58.5%, and the negative predictive values were between 80.9% and 89.5%. Conclusions: Although several serum markers were found to be significantly changed with current prospective cohort, their limited predictive values in preeclampsia development posed potential barrier in clinical implementation. Further studies with larger cohort are warranted to further reveal the clinical utilities of the serum markers in preeclampsia prediction.

scholarly journals Utility of Immunoblotting for Early Diagnosis of Toxoplasmosis Seroconversion in Pregnant Women

2011 ◽  
Vol 18 (11) ◽  
pp. 1908-1912 ◽  
Author(s):  
C. Jost ◽  
F. Touafek ◽  
A. Fekkar ◽  
R. Courtin ◽  
M. Ribeiro ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Transmission Rate ◽  
Immunoblot Analysis ◽  
Immunofluorescence Assay ◽  
Serum Samples ◽  
Content Type ◽  
Low Concentrations ◽  
Qualitative Test ◽  
First Time

ABSTRACTCongenital transmission ofToxoplasma gondiioccurs mainly when a mother acquires the infection for the first time during pregnancy. It was recently shown that although early treatment of the primary infection during pregnancy has little or no impact on the fetomaternal transmission rate, it does reduce the incidence of sequelae in infected infants. Seroconversion is defined by the appearance of IgG. Commercial reagents continue to vary considerably in detecting low concentrations of antibodies, as during early seroconversion. We compared two routinely used immunoassays (IA) (Platelia and Elecsys Toxo IgG) and an indirect immunofluorescence assay (IIF) with a qualitative test based on immunoblot analysis (Toxo II IgG) (IB) to assess their abilities to diagnose seroconversion at its earliest stages. This prospective study was carried out between January and November 2010. It included 39 pregnant women with monthly follow-up who seroconverted during pregnancy. On first sera that were IgM positive but IgG negative (or equivocal) as detected by IA, IB diagnosed seroconversion twice as often as IIF (26/39 [66.7%] versus 13/39 [33.3%];P< 0.001; χ2test). Serum samples were retaken 2 to 5 weeks later for the other 13 cases (IgG negative by IB on first serum). Seroconversion was demonstrated as follows: IB for 5 cases where IA remained negative or equivocal, IB and IIF for 5 cases where IA remained negative or equivocal, IA for 2 cases, and no method for 1 case (a third sample was necessary). In summary, IB permitted toxoplasmosis seroconversion diagnosis before other means in 92.3% of cases (36/39) and thus earlier therapeutic intervention.

scholarly journals Effect of Sex and Assay Method on Serum Concentrations of Growth Hormone in Patients with Acromegaly and in Healthy Controls

2006 ◽  
Vol 52 (3) ◽  
pp. 468-473 ◽  
Author(s):  
Helene Markkanen ◽  
Tuula Pekkarinen ◽  
Matti J Välimäki ◽  
Henrik Alfthan ◽  
Ritva Kauppinen-Mäkelin ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Tolerance Test ◽  
Reference Intervals ◽  
Assay Method ◽  
Specific Reference ◽  
Oral Glucose ◽  
Serum Samples ◽  
Serum Growth Hormone ◽  
The Difference

Abstract Background: Diagnosis and follow-up of acromegaly is based on measurements of serum growth hormone (GH) concentrations during an oral glucose tolerance test (OGTT). A nadir value &lt;1 μg/L is commonly used to define a normal response, but some authors suggest lower cutoff values. Methods: To compare the results and subsequent patient classification obtained with 3 GH assays, we obtained basal serum samples from 78 apparently healthy adult controls (43 women and 35 men; median age, 32.5 years) and from 71 treated (44 women and 27 men; median age, 55.2 years) and 7 untreated acromegaly patients (4 women and 3 men; median age, 54.6 years), and OGTT was performed on all patients and on 72 of the 78 controls. GH was determined by 2 immunometric assays—a double monoclonal (AutoDELFIA; Wallac) and a monopolyclonal (Immulite 2000; DPC) assay—and in a limited set of samples by an RIA (Spectria RIA; Orion). Results: There was a strong correlation (r = 0.995; P &lt;0.001) between the 2 immunometric methods, but the results obtained with the Immulite 2000 were, on average, 1.4-fold higher than those obtained with the AutoDELFIA. At concentrations around the cutoff (1 μg/L), however, the difference was ∼2-fold. Overall, the Orion RIA method also showed a good correlation (r = 0.951–0.959) with the other methods, but it did not measure concentrations &lt;2 μg/L. Women had higher basal and OGTT nadir GH concentrations than men. Conclusion: Reference intervals should be determined separately for each method, and the need for establishing sex-specific reference values should be investigated.

scholarly journals Prenatal Care in Israel: A Doctor – Nurse Dual Model

2016 ◽  
Vol 1 (2) ◽  
Keyword(s):  
Prenatal Care ◽  
Pregnant Women ◽  
Health Care Providers ◽  
Standard Care ◽  
Normal Pregnancy ◽  
Mental Condition ◽  
Health State ◽  
Dual Model ◽  
Care Providers

Background: Studies have shown significantly lower risk of complications during labor following prenatal care, allowing early detection, promoting normal pregnancy and birth. In May 2013 Maccabi Health Services launched “prenatal personal care” - a dual gynecologist and nurse follow up model. Our goals were to Preserve and promote physical and mental condition of pregnant women and conduct early identification of high risk situations and intervention. Methods: The model is based on periodic visits provided by 150 designated nurses and 200 gynecologists working in collaboration. The follow up consists of 4-6 visits through pregnancy period. Additional visits provided according to woman’s health state. The intervention includes information on recommended tests, abnormal conditions, preliminary screening for depression during pregnancy (Edinburgh questionnaire) and counseling. Various communication services such as Facebook, email, phone, app and personal meetings are available. The model maintains interfaces with other health care providers such as dieticians, pelvic floor physical therapists, social workers and others. A designated computerized record was developed allowing generate and transparent follow up. Results: Prenatal care was given to 22% of pregnant women. 58% of them were vaccinated for pertussis compared to 22% in standard care. Depression screening found 0.4% positive answers to tendency for suicide, 11.5% were suspected for depression. In addition, 85.6% performed GCT test versus 74.3% with standard care. Conclusion: The model contributes to higher health outcomes and higher satisfaction among doctors, nurses and pregnant women. The service will be expanded to telehealth prenatal care allowing broader availability and accessibility for service nationwide.

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