Objective: To determine whether serum concentrations of insulin-like growth
factor-binding protein-1 (IGFBP-1), a major decidual protein, at 16 weeks'
gestation differ between women who later develop pregnancy-related hyperte
nsion and normotensive women.
Methods: Concentrations of IGFBP-1 were measured using immunoenzymometric a
ssay in serum samples collected for alpha-fetoprotein (AFP) and free beta s
ubunit of hCG (free beta-hCG) determinations in a Down syndrome screening p
rogram at 16 weeks' gestation in a population-based cohort of 1049 nullipar
ous women. After exclusion of subjects with multiple pregnancies, insulin-d
ependent diabetes, major fetal malformations, and incomplete data, 917 subj
ects remained eligible.
Results: The mean levels (+/- standard deviation) of IGFBP-1 were significa
ntly lower in 34 women who later developed preeclampsia (73 +/- 43 mu g/L,
P < .01) and in 80 women with White A diabetes (84.7 +/- 53 mu g/L, P < .01
) compared with controls (103 +/- 58 mu g/L). In seven women with White A d
iabetes and subsequent preeclampsia IGFBP-1 levels were especially low (41
+/- 34 mu g/L). The concentrations of AFP and free beta-hCG in the subgroup
s with hypertensive disorders were not significantly different from those o
f normotensive women.
Conclusion: Decreased IGFBP-1 levels at 16 weeks' gestation in women who de
velop preeclampsia might indicate impaired decidual function. Hyperinsuline
mia, a known risk factor for preeclampsia, might contribute to decreased co
ncentrations of serum IGFBP-1. However, due to low sensitivity, assay of se
rum IGFBP-1 was not clinically valuable for predicting preeclampsia. (C) 20
00 by The American College of Obstetricians and Gynecologists.