Increased fetal leptin in type I diabetes mellitus pregnancies complicated by chronic hypoxia.
OBJECTIVE
The purpose of this study was to examine whether fetal leptin concentration correlates with severity of chronic or subchronic fetal hypoxia as indicated by increased fetal concentrations of erythropoietin in fetuses of mothers with Type I (insulin dependent) diabetes mellitus.


METHODS
We measured leptin and erythropoietin concentrations in cord plasma and amniotic fluid with radioimmunoassay in 25 pregnancies (gestational age 37.2 +/- 1.0 weeks). Fetuses with amniotic fluid erythropoietin over 22.5 mU/ml were classified as hypoxic (n = 9) and those with amniotic fluid erythropoietin below 22.5 mU/ml (n = 16) as non-hypoxic.


RESULTS
The hypoxic fetuses had significantly higher cord leptin concentrations than non-hypoxic fetuses (median 36.8; range, 12.5-135.1 vs median 16.2; range, 3.7-52.2 micrograms/l), (p = 0.0066). Cord plasma leptin (n = 25) correlated directly with amniotic fluid erythropoietin (r = 0.727, p = 0.0001), with cord plasma erythropoietin (r = 0.644, p = 0.0005) and with the maternal last trimester HbA1C (r = 0.612, p = 0.0019) and negatively with cord artery pO2 (r = -0.440, p = 0.032), and pH (r = -0.414, p = 0.040).


CONCLUSIONS
Fetal leptin concentrations increased concomitantly with erythropoietin during chronic or subchronic hypoxia. This phenomenon could indicate a role for leptin in fetal adaptation to hypoxia.
Hytinantti
T K
TK
Helsinki City Maternity Hospital, Helsinki University Central Hospital, Finland.
Koistinen
H A
HA
Teramo
K
K
Karonen
S L
SL
Koivisto
V A
VA
Andersson
S
S
D000653:Amniotic Fluid / Q000737:chemistry; D001724:Birth Weight; D001824:Body Constitution; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D004921:Erythropoietin / Q000032:analysis / Q000097:blood; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D005311:Fetal Hypoxia / Q000097:blood / Q000503:physiopathology*; D005865:Gestational Age; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007231:Infant, Newborn; D020738:Leptin / Q000032:analysis / Q000097:blood*; D008297:Male; D011247:Pregnancy; D011254:Pregnancy in Diabetics; D012016:Reference Values; D012044:Regression Analysis
D004921:Erythropoietin; D006442:Glycated Hemoglobin; D020738:Leptin