Surabhi Nanda, Ranjit Akolekar, Isabela C Acosta, Dorota Wierzbicka and Kypros H Nicolaides
Objective: To examine maternal serum levels of leptin at 11-13 weeks gestation in normal and pathological pregnancies.
Methods: Serum leptin, PAPP-A and uterine artery pulsatility index (PI) at 11-13 weeks were measured in 480 singleton pregnancies, including 240 with normal outcome, 60 that subsequently developed preeclampsia (PE), 60 that developed Gestational Diabetes Mellitus (GDM), 60 that delivered Large for Gestational Age (LGA) neonates and 60 that delivered small(SGA) neonates. Regression analysis was used to determine factors affecting maternal serum leptin concentration and from this model each value was expressed as Multiples of the Median (MoM). The median MoM values in the outcome groups were compared.
Results: In the normal group serum leptin levels increased with maternal weight and decreased with maternal height. In the PE group, the median leptin (1.18 MoM, p=0.027) and uterine artery PI (1.25 MoM, p<0.0001) were increased and serum PAPP-A (0.72 MoM, p<0.0001) was decreased. There was no significant association between serum leptin and either uterine artery PI (p=0.983) or serum PAPP-A (p=0.403). In the SGA, LGA and GDM groups serum leptin MoM was not significantly different from the controls (p=0.621, p=0.385 and p=0.722, respectively).
Conclusion: In conclusion, in pregnancies that develop PE, maternal serum leptin concentration at 11-13 weeks is increased in a manner not related to altered placental perfusion or function. In pregnancies complicated by the development of GDM or delivery of SGA or LGA neonates, serum leptin is not significantly altered.
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