Neonatal IGF-1/IGFBP-1 axis and retinopathy of prematurity are associated with increased blood pressure in preterm children

Abstract

Aim Preterm children are at risk of developing increased blood pressure (BP). We evaluated possible associations between BP, early insulin-like growth factor-1 (IGF-1) and IGF-binding protein-1 (IGFBP-1) levels and retinopathy of prematurity (ROP) in preterm children. Methods The study included 32 infants: median gestational age 28.1 weeks (range 24.6-31.3) and birthweight standard deviation scores (SDS) (±SD) 1.0 ± 2.7. IGF-1 and IGFBP-1 at postnatal weeks 32.6-34.6 and ROP stages were established after birth. BP was measured at the age of 4 years. The ratio (IGF-1)2/IGFBP-1 was created to investigate the influence of both IGF-1 and IGFBP-1 to later BP. Results Diastolic BP correlated with IGFBP-1, inversely correlated with IGF-1 and IGF-12/IGFBP-1 (r = -0.71, p < 0.0001) and positively correlated with catch-up growth velocity from lowest weight SDS to age 36.5 weeks (r = 0.48, p < 0.01), independent of gestational age. Children with moderate-to-severe ROP as neonates had higher mean arterial BP [78 (±95%CI 74-83) vs 71 (±95%CI 68-75) mm Hg, p < 0.05] adjusted for gestational age and birthweight SDS compared to children diagnosed with no to mild ROP. Conclusion Low neonatal IGF-12/IGFBP-1 and severe ROP were associated with higher BP in 4-year-old children born very preterm and may thus predict future cardiovascular morbidity. © 2013 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd.