Association Between Relative Cord Hyperleptinemia and Offspring Outcomes in Pregnant Women With Overweight or Obesity.

BACKGROUND/

OBJECTIVES

Umbilical cord leptin is increased in infants of women with obesity. We tested the hypothesis that a high cord leptin-to-fat mass ratio might be associated with adverse outcomes at birth and in early childhood.

METHODS

A secondary analysis of vitamin D And Lifestyle Intervention for gestational diabetes mellitus prevention (DALI) trial was conducted. Cord leptin-to-fat mass ratios were classified into top (TT), middle, and low (LT) tertiles overall and within sexes. Relationship with neonatal outcomes and offspring BMI z-scores were compared between TT and LT groups.

RESULTS

Among 323 infants (maternal pre-pregnancy BMI 33.7 ± 4.2 kg/m2, 52% male) female (vs. male) offspring had higher cord leptin, fat mass percentage, and leptin-to-fat mass ratio (median (IQR): 21.4 (13.4, 30.99) vs. 15.5 (8.3, 25.9), p < 0.001). Compared to the LT group, infants in the TT group (58% females) had higher cord leptin but similar fat mass percentage. Among males (but not in females), the C-peptide-to-glucose ratio was elevated in the TT group (vs. LT) (0.2 (0.1-0.2) vs. 0.1(0.02-0.2), p < 0.001), while birthweight (3.5 ± 0.5 vs. 3.7 ± 0.4 kg, p = 0.045), fat mass percentage (11.1 ± 3.9 vs. 13.0 ± 3.6, p = 0.008), and BMI z-scores (at age 1 only) were lower (median (IQR): -0.15 (-0.67, 0.98) vs. 1.35 (-0.06, 1.67), p = 0.03).

CONCLUSIONS

Relative cord hyperleptinaemia was associated with reduced offspring BMI among males.