To evaluate predictability of estimation of serum levels of
glycodelin A (GdA), insulin growth factor-1 (IGF-1) and its binding
protein-3 (IGFBP-3) at the 4th week gestation age (GA) for
development of early pregnancy loss (EPL) in primigravida with
polycystic ovary syndrome (PCOS).
Patients & Methods: The study included 45 primigravida PCOS
women developed EPL (Study group) and 45 primigravida PCOS
women completed the observation period uneventfully (Control group).
At the 4th wk GA, all women underwent clinical examination and
pregnancy was assured, then all women gave fasting blood samples for
estimation of fasting blood glucose (FBG), serum insulin, GdA, IGF-1
and IGFBP-3. Insulin resistance (IR) was evaluated using the
homeostasis model assessment IR (HOMA-IR) score.
Results: Study women had significantly higher FBG and
HOMA-IR score than control women. Estimated 4-wk GA serum levels
of IGF-1 were significantly higher, while serum IGFBP-3 and GdA
were significantly lower in study versus control PCOS women.
Development of EPL showed positive significant correlation with high
FBG, HOMA-IR score and high serum IGF-1 levels, while showed
negative significant correlation with serum IGFBP-3 and GdA levels.
Statistical analyses defined high serum IGF-1 as significant sensitive
predictor, while low serum glycodelin A, IGFBP-1 and FBG as specific
predictors for development of EPL, in decreasing order of significance.
Conclusion: Low serum GdA and IGFBP-3 levels and high IGF-1
levels estimated at the 4th wk GA may underlie the development of EPL
in pregnant PCOS women. Estimation of three markers as multiple
marker panels could predict EPL with high sensitivity and specificity. |
