胎盘组织中胰岛素样生长因子-1基因表达与巨大儿发生的相关性分析

Analysis on the correlation between expression of insulin-like growth factor-1 gene in placenta and the occurrence of macrosomia

目的探讨胎盘组织中胰岛素样生长因子-1(IGF-1)基因表达水平与巨大儿发生的相关性,为临床上巨大儿的预测提供参考。方法选取2015年1月-2016年12月在武汉市妇女儿童医疗保健中心分娩的67例足月巨大儿为观察组,同期分娩的80例体重正常新生儿为对照组,对比两组巨大儿在妊娠期的一般资料,并采用实时荧光定量PCR技术检测两组胎盘组织IGF mRNA表达水平,采用Logistic多因素分析模型探讨IGF-1基因表达与巨大儿发生的关系。结果观察组孕妇孕龄、孕前体重、孕期增重和孕期羊水量均显著高于对照组(P<0.05),观察组盘组织中IGF-1mRNA表达水平显著高于对照组(P<0.05),采用非条件Logistic回归分析建模,孕前体重过重(OR=1.528)、妊娠期增加体重过大(OR=1.611)、胎盘组织中IGF-1 mRNA高表达水平(OR=1.209)是发生巨大儿的危险因素(P<0.05)。结论孕前体重过重、妊娠期增加体重过大、胎盘组织中IGF-1 mRNA高表达是发生巨大儿的独立危险因素。

Objective To explore the correlation between expression of insulin-like growth factor- 1 （ IGF- 1 ） gene in placenta and the occurrence of macrosomia, and provide a reference for predicting macrosomia. Methods From January 2015 to December 2016, 67 cases of full-term macrosomia born in Wuhan Women and Children＇s Health Care Center were selected as observation group, and 80 neonates with normal weight born during the same period were selected as control group. The general situations during pregnancy in the two groups were compared. Real-time fluorescent quantitative PCR was used to detect the expression levels of 1GF mRNA in placental tissues of the two groups. Multivariate logistic model was used to explore the relationship between IGF-1 gene expression and macrosomia. Results Gestational age, prepregnancy weight, body weight gain during pregnancy, and amniotic fluid volume during pregnancy in observation group were statisti- cally significantly higher than those in control group （ P〈0.05 ） . The expression level of IGF- 1 mRNA in placenta of observation group was statistically significantly higher than that of control group （ P〈0.05 ） . Nonconditional logistic analysis showed that high prepregnancy weight （OR=1. 528）, high body weight gain during pregnancy （OR = 1.611 ）, and high expression level of IGF-1 mRNA in placenta （OR = 1. 209） were risk factors of macrosomia （P〈0. 05） . Conclusion High prepregnancy weight, high body weight gain during pregnancy, and high expression level of IGF-1 mRNA in placenta are independent risk factors of macrosomia.