1. CORD BLOOD TGF -α
CONCENTRATIONS AT TERM ARE
NOT AFFECTED BY
INTRAUTERINE GROWTH
RESTRICTION
Sofia Liosi 1 , Despina D. Briana 1 , Maria Boutsikou 1 ,
Dimitrios Gourgiotis 2 , Stavroula Baka 1 , Maria
Palatianou 2 , Dimitrios Hassiakos 1 , Ariadne MalamitsiPuchner 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-α
• a 50 amino acid polypeptide
• a member of the EGF family
• TGF-α mRNA and immunoreactive TGF-α
have been isolated from human placenta
in all three trimesters

3. TGF-α
• stimulates mitosis and angiogenesis in
the human placenta
• promotes proliferation and differentiation
in the fetal and neonatal gastrointestinal
tract

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
• compromised
placental formation
• impaired
angiogenesis
• increased incidence
of necrotizing
enterocolitis, due to
hypoxic-ischaemic
injury

6. HYPOTHESIS
• Umbilical cord blood concentrations of
TGF -α in IUGR cases may differ from
respective concentrations in appropriatefor-gestational-age (AGA) controls due to
impaired angiogenesis and increased
incidence of necrotizing enterocolitis. .

7. AIM
•
Investigate cord blood TGF -α
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- 400 g)
• Apgar scores: > 8 in 1 st and 5 th minute

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Weight (GROW) computergenerated programme
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10. 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 )

11. 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

12. Methods
•
•
•
Blood collected from:
Doubly-clamped umbilical cords (m ixed
arteriovenous blood ) – reflecting fetal
state
Determination of plasma TGF -α
concentrations by enzyme immunoassay
( Human ELISA, RayBiotech Inc)
Statistical analysis (non-parametric
tests)

13. TGF A CONCENTRATIONS (pg/ml)
Fig. 1 Box and whiskers plots of the umbilical
cord concentrations of TGF -α from IUGR cases
and AGA controls.
250
200
150
100
50
0
AGA GROUP
(N=110)
IUGR GROUP
(N=50)

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

15. Results (2)
• In a combined group
• Cord blood TGF -α concentrations were
significantly elevated in cases of vaginal
delivery

16. Results (3)
• The effect of birth weight, customized
centile, gestational age or maternal age
on TGF -α concentrations was not
significant.

17. Conclusions (1)
• Cord blood TGF- α concentrations in full-term
pregnancies are independent of intrauterine
growth
• Lack of differences in cord blood TGF- α
concentrations between IUGR and AGA groups
at term possibly suggests that TGF- α may not
be directly involved in the impairment of
placental and intestinal growth, characterizing
IUGR.

18. Conclusions (2)
• Stress associated with vaginal delivery
may account for the higher
concentrations in the latter.
TGF- α