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Cord blood and postnatal serum leptin and its relationship to steroid use and growth in sick preterm infants
P S Shekhawat1, J S Garland, C Alex
1Department of Pediatrics, Washington University School of Medicine, St. Louis, MO 63110, USA. Shekhawat_P@kids.wustl.edu
Insights
Prenatal and postnatal glucocorticoid use in sick preterm infants was linked to higher serum leptin levels and potentially poorer weight gain. Caloric intake did not correlate with weight gain in this study.
Area of Science:
- Neonatal Research
- Endocrinology
- Pediatric Nutrition
Background:
- Glucocorticoids are frequently used in preterm infants to manage respiratory distress.
- Leptin, a key metabolic hormone, plays a role in energy balance and adiposity.
- The impact of glucocorticoid exposure on leptin levels and growth in preterm infants requires further investigation.
Purpose of the Study:
- To investigate the association between prenatal and postnatal glucocorticoid administration and serum leptin concentrations in sick preterm infants.
- To examine the relationship between serum leptin levels and weight gain in these infants.
- To explore the correlation between caloric intake and weight gain in the context of glucocorticoid use.
Main Methods:
- Serum leptin levels were measured in 24 preterm neonates at birth (cord blood), and on postnatal days 14 and 28.
- Total caloric intake (enteral and parenteral) and infant weight were recorded on days 14 and 28.
- Radioimmunoassay was used for serum leptin quantification.
Main Results:
- Infants born to mothers who received antenatal steroids exhibited significantly higher cord blood leptin levels.
- Postnatal serum leptin concentrations showed a significant increase from birth to day 28 of life.
- A significant inverse exponential correlation was observed between mean serum leptin and postnatal weight gain by day 28 (R²=0.56).
- Total caloric intake did not correlate with postnatal weight gain at days 14 and 28.
Conclusions:
- Elevated serum leptin concentrations in preterm infants following glucocorticoid exposure may be associated with impaired weight gain.
- These findings suggest a potential mechanism linking glucocorticoid therapy to altered metabolic programming and growth outcomes in vulnerable preterm infants.
Objective:
To study the effect of prenatal and postnatal glucocorticoids use on serum leptin and weight gain in sick preterm infants and its correlation with caloric intake.
Methods:
Serum leptin was measured in 24 neonates at day 1 (cord), 14 and 28 by radioimmunoassay. Total caloric intake (enteral and parenteral) and weight were measured on days 14 and 28 of life.
Results:
Mean birth weight and gestational age of study infants were 864 +/- 273 g (mean +/- SD) (range 520-1755 g), and 26.6 +/- 2.4 weeks (23-32 weeks) respectively. Cord blood leptin was greater in infants whose mothers received antenatal steroids (1.98 +/- 1.05 ng/ml vs 0.94 +/- 0.39 ng/ml, p=0.004). Serum leptin increased postnatally from 1.52 +/- 1.0 ng/ml at birth to 2.2 +/- 1.3 ng/ml on day 28 of life (p=0.03). Mean serum leptin had an inverse exponential relationship with postnatal weight gain by day 28 of life (R2=0.56). Total caloric intake on days 14 and 28 of life did not correlate with postnatal weight gain.
Conclusions:
Increased serum concentration of leptin following glucocorticoids may be associated with poor weight gain in sick preterm infants.
