Reproduction Abstracts

Leptin is implicated to be altered in pathological pregnancies. We followed up 312 singleton mothers from 12 to 14 weeks gestation (booking) until delivery. Majority had a normal pregnancy (n=253). Others developed complications (gestational diabetes mellitus (GDM): n=13, pregnancy induced hypertension/pre eclampsia (PIH/PE): n=27, intrauterine growth retardation (IUGR): n=17, and other: n=2). Plasma leptin at booking visit and in the third trimester (referred to as term) were measured by ELISA. Leptin levels (booking visit and term) significantly differed between groups (geometric mean (95% CI) booking: 30.52 (25.69–36.26), 31.37 (29.16–33.74), 20.37 (29.16–33.74), and 13.86 (11.81–16.72) and term: 57.97 (51.11–65.75), 75.02 (69.41–81.08), 43.03 (41.50–44.61), and 26.36 (23.57–29.47) ng/ml in GDM, PIH/PE, normal pregnancy and IUGR respectively; Kruskal–Wallis ANOVA: P<0.0001). GDM and PIH/PE had higher leptin levels (Dunn’s multiple comparison: P<0.05) than normal pregnancy and IUGR. Leptin levels were lower in IUGR than in normal pregnancy (P<0.05). On normalization to BMI, leptin levels were no longer significantly different between normal pregnancy and GDM (booking and term) or IUGR (booking). Maternal weight gain and birth weight were also significantly different between groups as expected (one-way ANOVA: P<0.0001) with former being higher in GDM and PIH/PE, and lower in IUGR. Birth weights were higher in GDM and lower in PIH/PE and IUGR. Higher leptin levels seen in early and late pregnancy in PIH/PE, and lower leptin levels seen in late pregnancy in IUGR even when accounted for BMI, suggest that maternal leptin levels are modulated by different factors in IUGR and PIH/PE despite both leading to low birth weight.