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Early postnatal growth in preterm infants and cord blood leptin
Vania Matos Fonseca1, Rosely Sichieri, Maria Elizabeth Lopes Moreira
1Instituto de Medicina Social da Universidade do Estado de Rio de Janeiro, Maracanã, Rio de Janeiro, RJ, Brazil.
Insights
Lower cord blood leptin levels in premature infants are linked to better catch-up growth in BMI and length. Insulin levels did not show a significant predictive association with growth rates in preterm babies.
Area of Science:
- Neonatology
- Pediatric Endocrinology
- Growth and Development
Background:
- Circulating leptin and insulin are associated with intrauterine growth and birth weight in term infants.
- The role of cord blood leptin and insulin in catch-up growth of preterm infants remains unexplored.
Purpose of the Study:
- To investigate the association between cord blood leptin and insulin concentrations and subsequent growth in preterm infants.
- To determine if these hormones predict catch-up growth in terms of BMI and length over the first six months corrected age.
Main Methods:
- A cohort of 96 premature infants was studied.
- Cord blood samples were analyzed for leptin and insulin levels.
- Anthropometric measurements were tracked over 6 months corrected age.
- Repeated random regression (PROC MIXED in SAS) was used to analyze temporal changes in growth parameters.
Main Results:
- Cord blood leptin showed a negative association with the rate of change in Body Mass Index (BMI) and length from birth up to 64 postnatal weeks (p=0.01 for BMI, p<0.001 for length).
- Cord blood insulin was positively associated with BMI change rate (p=0.03), but this association was not significant after adjusting for birth weight.
- Lower leptin levels at birth were associated with greater catch-up growth in both BMI and length.
Conclusions:
- Leptin levels measured in cord blood are a significant predictor of growth rates in preterm children.
- Insulin levels at birth do not appear to be a reliable predictor of catch-up growth in this population.
- This study provides novel evidence linking lower cord leptin to enhanced catch-up growth in preterm infants.
Abstract:
Although circulating leptin and insulin concentration is linked to intrauterine growth, fetal development and birth weight in full-term infants, there has been no enquiry into the influence of cord blood insulin and leptin for catch-up growth in preterm infants. The study evaluated the association of cord blood leptin with growth and weight gain of 96 premature babies during 6 months (corrected age). The temporal changes of anthropometric indexes over this period were calculated by repeated random regression (PROC MIXED) using SAS. Cord blood leptin was negatively associated with the rate of change in BMI (p=0.01) and length (p<0.001), from birth until 64 postnatal weeks. Insulin was positively associated with the change rate in BMI (p=0.03); however, this disappeared when adjusted for birth weight. For the first time, the association between lower leptin levels with greater catch up growth is shown for both BMI and length among preterm children. In conclusion, leptin levels at birth, but not insulin levels, predict growth rates.
