Introduction:
Leptin is a hormone secreted by adipocytes that circulates in proportion to body fat. Placenta also produces leptin suggesting a specific role during pregnancy, maybe contributing to pregnancy-induced insulin resistance.
Objective:
To determine the associations between maternal levels of leptin, glucose and insulin and weight/adiposity measures in newborns.
Methods:
A population-based cohort of pregnant women in the region of Sherbrooke, Canada was recruited in early pregnancy (n=1040 at 1
st
trimester). Maternal anthropometry was measured and blood samples were collected at the 1
st
and 2
nd
trimesters to measure glucose (hexokinase), leptin and insulin (ELISA Luminex, Millipore Canada). Birth weights were recorded from the medical records in 783 newborns (full term >36 weeks). We measured skinfolds in 199 newborns within 72h after birth, using a standardized caliper. We measured triceps, biceps, subscapular and supra-iliac skinfolds and the sum of skinfolds was used for analysis representing overall neonatal adiposity. Correlations and linear regression analyses were performed to evaluate the associations between maternal metabolic characteristics and neonatal weight/adiposity measures.
Results:
Birth weight was associated with maternal body mass index (BMI; r=0.18 and r=0.20 at 1st and 2
nd
trimesters respectively; both
P
<0.001), percent body fat (%bf; r=0.25;
P
<0.001), weight gain over pregnancy (r=0.14;
P
<0.001), and fasting leptin (r=0.15,
P
<0.001). Surprisingly, crude birth weight was not associated with maternal glycemic or insulin levels at 1
st
or 2
nd
trimesters (all
P
>0.05). In contrast, sum of skinfolds was associated with maternal fasting glucose (r=0.17,
P
=0.01) and fasting insulin (r=0.24,
P
=0.001), in addition to fasting leptin (r=0.18,
P
=0.01) at 2
nd
trimester. Sum of skinfolds was also associated with maternal BMI (r=0.18,
P
=0.008 at 1
st
and r=0.21,
P
=0.003 at 2
nd
trimester) and %bf (r=0.19;
P
=0.005). After adjustments for maternal BMI or %bf, sum of skinfolds remained significantly associated with maternal fasting insulin (all
P
<0.05), but not with maternal leptin levels (
P
=0.16 to 0.35)
Conclusion:
These results suggest that maternal insulin/glycemic regulation has a greater impact on neonatal adiposity than overall crude birth weight. Birth weight and neonatal adiposity are both associated with maternal leptin levels, likely representing maternal own adiposity levels that might influence neonatal outcomes directly or indirectly.