Document Type : Original Article
Authors
1
Department of Pediatrics, Faculty of Medicine, Minia University, El-Minya, Egypt.
2
Department of Pediatrics, Faculty of Medicine, Minia University, El-Minya, Egypt
3
2 Departments of Clinical Pathology, Faculty of Medicine, Minya University, El-Minya, Egypt
Abstract
Background: Fetal macrosomia, or otherwise large-for-gestational - age (LGA) fetus/infant,
applies to birth weight (BW) between 4000 and 4500g, and BW > 90th percentile for
gestational age. Cardiotrophin-1(CT-1), cardiomyocytes-produce chemokine, member of the
interleukin- 6 cytokine family, which acts upon the glycoprotein (GP) 130 trans- membrane
receptor, plays fundamental role in fetal heart development this is up-regulated by hypoxia
and inflammation and exerts potent hypertrophic action on cardiac cells. It mediates the
hyperglycemia/hyperinsulinemia-induced myocardial hypertrophy and systemic atherosclerosis, and are actively involved in cardiovascular pathology. Aim of the study: To evaluate the
Cardiotrophin-1level and echocardiographic findings in the macrosomic neonate's in maternity
and children hospital. Methods: It is a case control study. A total 80 neonates enrolled. They
were divided into 2 groups; 40 neonates' were macrosomic, 40 neonates control were healthy. Cord
blood was collected and analyzed for plasma level of cardiotrophin-1 and echo study for cases
and control. The two groups were subjected to careful detailed history perinatal history,
complete clinical examination, echo study, and laboratory investigations including plasma
level of cardiotrophin-1, random blood sugar. Results: There was a significant difference in
weight, length, body area surface of macrosomic neonates at p <0.001. CT-1 is significantly
high in Macrosomic neonates p<0.001. ASD was comment defect in our study present in
eighteen (56.3%) Macrosomic neonates, while the increase in IVSD was highly significant in
macrosomic neonates compared to control. A subgroup analysis (in the Macrosomic group)
showed increased cord blood CT-1 concentrations in Macrosomic neonates with CHD, as
compared to Macrosomic neonates without CHD (p1 =0.029). Subgroup analysis (in the
Macrosomic group) showed increased cord blood CT-1 concentrations in IDM median
280(pg. /mL) as compared to controls median 59(pg. /mL) p2 <0.001, CT-1 concentrations
was significantly elevated in Macrosomic of IDM Median 280(pg. /mL) as compared to
Macrosomic of Non-diabetic mothers p1<0.001, but still significantly high in Macrosomic
neonates of Non-diabetic mothers Median was 280 (pg. /mL) versus (59) in control p3<0.001.
CT-1 concentrations were similar in Macrosomic with CHD and Macrosomic without CHD
neonates, and positively correlated with Infant RBS (r =0.949, r = 0.948 respectively
p<0.001). CT-1 concentrations were positively correlated with body surface area and birth
weight in Macrosomic with CHD (r =0.888, r =0.800 respectively) and Macrosomic without
CHD neonates (r =0.917, r =0.920 respectively). Conclusion: plasma cardiotrophin-1 level is
significant high in macrosomic neonates, cardiac hypertrophy and anomalies are common on
macrosomic neonates.
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