183-OR: Placental Growth Factor and Fetal Growth in Women with Type 1 Diabetes Mellitus

Autor:	Dylan Burger, George Tomlinson, Helen R. Murphy, Siobhan Bacon, Denice Feig, Mayur Tailor
Rok vydání:	2019
Předmět:	Placental growth factor medicine.medical_specialty business.industry Offspring Endocrinology Diabetes and Metabolism Birth weight Gestational age Endocrinology medicine.anatomical_structure PIGF Internal medicine Placenta Internal Medicine Gestation Medicine business Glycemic
Zdroj:	Diabetes. 68
ISSN:	1939-327X 0012-1797
Popis:	Background: Maternal hyperglycaemia alone does'nt explain the incidence of large for gestational age offspring (LGA) amongst women with T1DM. Placental vascular development is regulated by angiogenic factors. Placental growth factor (PIGF) is such a factor with a PlGF >100 signifying a well-developed placenta. Co-measurement of PlGF and SFLT-1 (soluble receptor antagonist to VEGF), combined as a ratio, is predictive of maternal vascular perfusion. A low sFLT-1:PlGF ( Methods: Amongst 157 women who participated in CONCEPTT; PlGF, sFLT-1:PlGF and a HbA1c< or >6.5% at randomisation and 34 weeks' gestation were assessed. Two separate linear regression models were used to test for a differential effect of placental function on mean birth weight in those with different levels of glycemic control, one using sFLT-1:PlGF and the other PlGF. Results: No significant relationship was found between birthweight and markers of placental function and glycemic control at randomisation. At 34 weeks, the relationship of birth weight to sFLT-1: PlGF differed depending upon HbA1c (p=0.007). Where HbA1c< 6.5%, birth weights were similar for a sFLT-1:PlGF 85 (3699g). Where HbA1c > 6.5%, birthweights were higher with a sFLT-1:PlGF < 85 (3809g) vs. > 85 (3355g). A similar pattern emerged for PlGF alone, with a differential effect of a healthy placenta on birthweight dependent upon glycemic control (p=0.013). Where HbA1c6.5%, an elevated PlGF (>100) resulted in higher birth weight than in those with lower PlGF (3822g ±679 vs. 3344g ±556). Conclusion: In women with T1DM, the combination of a healthy placenta with poor glycemic control resulted in the highest birthweights. Tighter glycemic control to avoid LGA is needed in women with healthy placental function. Disclosure S. Bacon: None. D. Burger: None. M. Tailor: None. G.A. Tomlinson: None. H.R. Murphy: Advisory Panel; Self; Medtronic MiniMed, Inc. D. Feig: Advisory Panel; Self; Medtronic. Speaker's Bureau; Self; Medtronic.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::48a5ee676d13e7373c0248a7ef50b095 https://doi.org/10.2337/db19-183-or Zobrazit plný text záznamu