This study investigated transforming growth factor beta 1 (TGF-β1) concentrations in umbilical cord blood from pregnancies complicated by intrauterine growth restriction (IUGR) compared to appropriate-for-gestational-age (AGA) controls. The study found no significant differences in TGF-β1 concentrations between the IUGR and AGA groups. Higher TGF-β1 concentrations were associated with vaginal delivery and lower infant growth percentiles in the IUGR group. The results suggest TGF-β1 may be related to fetal growth but not directly involved in pathophysiological processes leading to IUGR.

1. CORD BLOOD TGF- β 1
CONCENTRATIONS IN
INTRAUTERINE GROWTH
RESTRICTED PREGNANCIES AT
TERM
Sofia Liosi 1 , Despina D. Briana 1 , Stavroula Baka 1 ,
Dimitrios Gourgiotis 2 , Maria Boutsikou 1 ,
Lamprini Stamati 2 , Dimitrios Hassiakos 1 , Ariadne
Malamitsi-Puchner 1 .
1.Neonatal Division, 2nd Department of Obstetrics and Gynecology, Athens
University Medical School, Athens, Greece
2.Research Laboratories, 2nd Department of Pediatrics, Athens University
Medical School, Athens, Greece

2. TGF – β1
• A member of the transforming growth
factor beta (TGF-β) family
• Three closely related isoforms TGF- β1,
TGF-β2, and TGF-β3

3. TGF-β1
• inhibition of cell growth and
transformation
• suppression of immune response
• promotion of inflammation
• a critical regulator of trophoblast
invasion and fetal growth.

4. Intrauterine growth
restriction-IUGR
• Failure of the fetus to achieve his/her
intrinsic growth potential
• Consequence of anatomical and/or
functional disorders and diseases in the
feto-placental-maternal unit
• Results to increased morbidity and
mortality in intra- and extrauterine life

5. IUGR
• abnormal trophoblast invasion
• uteroplacental vascular insufficiency
• impaired fetal growth

6. HYPOTHESIS
• Umbilical cord blood concentrations of
TGF -β1 in IUGR cases may differ from
respective concentrations in appropriatefor-gestational-age (AGA) controls, due
to uteroplacental vascular insufficiency

7. AIM
•
Investigate cord blood TGF -β1
concentrations in IUGR and AGA
pregnancies at birth
•
Correlate determined concentrations
with gestational age, gender and mode
of delivery.

8. SUBJECTS
• 160 healthy, singleton full-term
pregnancies
- 1 10 AGA (placental weight: 480-621 g)
- 50 asymmetric IUGR ( placental weight
230- 400g)
• Apgar scores: > 8 in 1 st and 5 th minute

9. Gestation Related Optimal
Weight (GROW) computergenerated programme
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10. DEMOGRAPHIC DATA
•
•
•
•
•
•
IUGR
Gestational age (weeks)
38 .36 ±1 .27 *
BW (g)
25 07 ± 264.5 *
BW centile
3 .0 (0-5)
Gender (male/female)
21/29
Mode of delivery (VD/ECS)** 22/28
Parity (1st /other)
31 / 19
* values are mean ± SD
**VD: vaginal delivery/ ECS: elective cesarian section
AGA
3 8.98 ± 1.07 *
3 310 ± 310.5*
44.5 (20-99)
66/44
77/33
76/34

11. CAUSES OF IUGR
• Preeclampsia ( n=6 )
• Pregnancy induced hypertension
(n=5 )
• Various diseases : severe type I DM
•
( n=5),iron deficiency anemia (n=3),
hypothyroidism (n=7)
Maternal smoking ( n=24 )

12. Methods
•
•
•
Blood collected from:
Doubly-clamped umbilical cords (m ixed
arteriovenous blood ) – reflecting fetal
state
Determination of plasma TGF -β1
concentrations by enzyme immunoassay
( Human TGF- β 1 ELISA, R&D OX, UK)
Statistical analysis (non-parametric
tests)

13. TGFB1 CONCENTRATIONS (pg/ml)
Fig. 1 Box and whiskers plots of the
concentrations of TGF β1 UC from AGA and IUGR
cases
30000
20000
10000
0
AGA GROUP
(N=110)
IUGR GROUP
(N=50)

14. Results (1)
• No statistically significant differences in
cord blood TGF -β1 concentrations
between IUGR and AGA groups .

15. Results (2)
• In a combined group
• Cord blood TGF -β1 concentrations were
significantly elevated in cases of vaginal
delivery
• The effect of gender, parity and maternal
age on cord blood TGF-β1
concentrations was not significant.

16. Results (3)
• In the AGA group
• Cord blood TGF-β1 concentrations were
higher in primigravidas

17. Results (4)
• In the IUGR group
• Cord blood TGF- β1 concentrations
negatively correlated with infant’s
customized centiles

18. Conclusions (1)
• Lack of differences in cord blood TGF- β 1
•
concentrations at term between IUGR
and AGA groups possibly suggests that
TGF- β 1 may not be directly involved in
the pathophysiological processes
resulting in IUGR
Gender, parity and maternal age do not
seem to have any impact on umbilical
cord blood TGF- β 1 concentrations

19. Conclusions (2)
• TGF-β1 may be related to fetal growth,
as indicated by the higher cord blood
TGF-β1 concentrations in primigravidas
and their negative correlation with
infants’ customized centiles in the IUGR
group

20. Conclusions (3)
• Stress associated with vaginal delivery
may account for the higher TGF-β1
concentrations in the latter.