Epidermal growth factor in maternal urine - a predictor of intrauterine growth restriction?

Epidermal growth factor (EGF), an angiogenic and mitogenic peptide, is know n to be essential for normal fetal development in mice. Hypothetically, low maternal urine EGF levels might be associated with intrauterine growth res triction (IUGR) or pre-eclampsia (PE). We carried out a prospective study o f 1009 consecutive women whose urine was sampled in early pregnancy (at a m edian of 13 weeks of gestation) between January and November 1993. Thirty w omen gave birth to IUGR babies and 24 developed PE. The study was designed as a nested case-control study with two matched controls for each case. EGF and human chorionic gonadotrophin (HCG) levels were measured and expressed in ng EGF/mg creatinine and IU HCG/mg creatinine. Logistic regression anal ysis was made with EGF or HCG levels as explanatory variables. Urinary EGF levels were significantly lower in the IUGR subgroup than in their controls , but no such difference was found between the PE subgroup and their contro ls. In the series as a whole, smokers were found to have lower EGF and HCG levels than non-smokers. In addition, correlation was found to exist betwee n EGF and HCG levels (Spearman's rho 0.35; P < 0.001). We conclude that a r elative deficiency of EGF in early pregnancy might be one of the pathophysi ological mechanisms of IUGR. However, the EGF level was an insufficiently d iscriminative variable to be of use for screening purposes. (C) 1999 Elsevi er Science Ireland Ltd. All rights reserved.