Serum IGF-1, IGF-1R and BDNF levels in GDM pregnant women and neonatal umbilical cord blood and their relationship with neonatal brain injury

Objective To investigate the serum levels of insulin-like growth factor 1 (IGF-1), IGF-1 receptor (IGF-1R), and brain-derived neurotrophic factor (BDNF) in pregnant women with gestational diabetes mellitus (GDM) and neonatal umbilical cord blood, and their effects on neonatal brain injury. Methods A total of 87 GDM pregnant women hospitalized for delivery at Yan'an University Affiliated Hospital from September 2020 to September 2023 were selected as the observation group. An additional 87 healthy pregnant women with normal deliveries during the same period were selected as the control group. Serum IGF-1, IGF-1R, and BDNF levels in the pregnant women and neonatal umbilical cord blood were compared between the two groups. Neonatal brain injury was assessed using the Neonatal Behavioral Neurological Assessment (NBNA) scale. Analysis of receiver operating characteristic (ROC) curve was performed to evaluate the predictive value of maternal serum and neonatal umbilical cord serum IGF-1, IGF-1R, and BDNF levels for neonatal brain injury. Results The incidence of neonatal brain injury in the observation group was higher than that in the control group (13.79% vs 2.30%, χ2=7.768, P=0.005). NBNA scores across all dimensions were lower in the observation group compared to the control group (P＜0.01). Maternal serum IGF-1 and BDNF levels were lower, while IGF-1R levels were higher in the observation group than in the control group (P＜0.05). Neonatal umbilical cord serum IGF-1 and BDNF levels were lower, and IGF-1R levels were higher in the observation group than in the control group (P＜0.01). ROC curve analysis showed that the area under the curve (AUC) for maternal serum IGF-1, IGF-1R, BDNF, and neonatal umbilical cord serum IGF-1, IGF-1R, BDNF in predicting neonatal brain injury was 0.668, 0.698, 0.656, 0.761, 0.709, and 0.666, respectively. Conclusion Pregnant women's serum and neonatal umbilical cord serum levels of IGF-1、 BDNF and IGF-1R are correlated with neonatal brain injury. Clinically, monitoring changes in maternal IGF-1, BDNF, and IGF-1R levels can help predict the incidence of neonatal brain injury.