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Gender, smoking during pregnancy and gestational age influence cord leptin concentrations in newborn infants

London Centre for Paediatric Endocrinology and Metabolism at Institute of Child HealthUniversity College London, London W1T 3AA, UK¹ Department of Obstetrics and GynaecologyRotunda Hospital, Dublin 1, Ireland² Department of Obstetrics and GynaecologyUniversity College London, London W1T 3AA, UK³ Program in Development and Fetal HealthSamuel Lunefield Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Canada M5G 1X5

(Correspondence should be addressed to P C Hindmarsh who is now at BEM Unit, Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK; Email: p.hindmarsh{at}ucl.ac.uk)

This is an Open Access article distributed under the terms of the Society for Endocrinology's Re-use Licence which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background: Low birth weight (BW), small head circumference, reduced length, increased preterm births and neuro-endocrine dysfunctions are among known consequences of smoking during pregnancy. Few studies have linked leptin to clinical features of growth restriction associated with maternal smoking and explored interaction with other determinants of size at birth, such as gender.

Methods: Cord serum leptin concentrations were measured in 1215 term infants born to Caucasian mothers at completion of uneventful pregnancy. Serum concentrations were related to BW, gestational length, gender and maternal smoking and interaction with other determinants of size at birth evaluated.

Results: Smoking was more frequent in younger (P<0.001) and shorter mothers (P=0.03) from lower socio-economic groups (SEGPs) (P<0.001). Infants born to smokers were lighter (190 g less), shorter and with smaller head circumference. Cord serum leptin concentrations were higher in girls (9.8 S.D. 7.6 ng/ml) than in boys (7.05 S.D. 5.8 ng/ml) (P<0.001). Boys were heavier (BW 3.52 S.D. 0.49 kg) than girls (3.39 S.D. 0.44 kg) (P<0.001), but girls had greater skinfold thickness measurements (sub-scapular and quadriceps skinfold thicknesses 5.5 S.D. 1.6 mm and 7.6 S.D. 1.9 mm respectively; boys 5.3 S.D. 1.6 vs 7.24±1.90 mm, P<0.001 respectively). Multivariate analyses showed gender (P<0.001), BW SDS (P<0.001), gestational length (P<0.001) and maternal smoking (P<0.042) as factors that influenced umbilical cord serum leptin concentrations in newborns.

Conclusion: Maternal smoking restrains foetal growth through placental vascular effects, and likely also via associated effects on leptin metabolism. More studies are needed to determine the influence that maternal smoking may have on placental syncytiotrophoblast and foetal adipose tissue.