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Published on: January 26, 2024
Pregnancy-induced hypertension, preterm birth, and cord blood adipokine levels
Elizabeth Soares da Silva Magalhães1, Maria Dalva Barbosa Baker Méio2, Fernando Maia Peixoto-Filho3
1Clinical Research Unit, Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Av. Rui Barbosa, 716, Flamengo, Rio de Janeiro, RJ, 22250-020, Brazil. emagalhaesiff@gmail.com.
Insights
Maternal hypertension significantly increases cord blood adipokines (leptin, adiponectin) in preterm infants. Ghrelin levels were higher in small-for-gestational-age infants and negatively correlated with birth measurements.
Area of Science:
- Perinatal Medicine
- Endocrinology
- Neonatology
Background:
- Maternal hypertension can disrupt hormonal balance, affecting fetal development.
- Adipokines play a crucial role in regulating fetal growth and metabolism.
- Hypertensive disorders of pregnancy may alter the intrauterine environment, impacting fetal metabolic programming.
Purpose of the Study:
- To investigate the impact of hypertensive disorders of pregnancy on cord blood adipokine levels in preterm infants.
- To correlate cord blood adipokine concentrations with anthropometric parameters in preterm neonates.
- To examine differences in adipokine profiles between infants exposed and unexposed to gestational hypertension.
Main Methods:
- Prospective cohort study involving pregnant women with and without hypertension and their offspring.
- Analysis of cord blood samples for leptin, adiponectin, and ghrelin using LUMINEX®.
- Comparison of adipokine levels between hypertensive and normotensive pregnancy groups using non-parametric statistical tests.
Main Results:
- Infants born to mothers with hypertensive pregnancies exhibited significantly higher cord blood leptin and adiponectin levels compared to controls.
- Adipokine levels were elevated in both appropriate-for-gestational-age (AGA) and small-for-gestational-age (SGA) infants within the hypertensive group.
- SGA infants in the hypertensive group had higher ghrelin levels than AGA infants, with ghrelin negatively correlating with birth weight, length, head circumference, and gestational age.
Conclusions:
- Gestational hypertension is associated with altered cord blood adipokine profiles at birth in preterm infants.
- Elevated adipokines in neonates exposed to maternal hypertension suggest potential long-term metabolic implications.
- Ghrelin levels in preterm SGA infants exposed to hypertension may indicate impaired fetal growth regulation.
Abstract:
Maternal hypertension may alter physiological parameters, dysregulating the release of hormones such as adipokines, thus influencing the fetal growth course. This study investigated whether hypertensive disorders of pregnancy alter cord blood adipokine levels and correlate these with anthropometric parameters in preterm infants. This is a prospective cohort study with pregnant women < 37-week gestation with and without hypertension and their offspring. Cord blood leptin, adiponectin, and ghrelin were analyzed by LUMINEX®. These adipokines were compared between the groups exposed or not to gestational hypertension using non-parametric statistical tests. The hypertensive pregnancies had significantly higher cord blood leptin (1.00 (IQR 0.67-1.20 ng/mL)) and adiponectin (18.52 (IQR 17.52-25.13 μg/mL)) levels than those without hypertension (0.07 (IQR 0.06-0.08 ng/mL) and 8.13 (IQR 6.50-8.68 μg/mL), respectively, p < 0.0001). The adipokine levels were higher in AGA and SGA infants in the exposed group for both moderate and late preterm. SGA had significantly higher ghrelin levels than the AGA infants. Ghrelin levels were negatively correlated with birth weight (r = - 0.613, p < 0.001), birth length (r = - 0.510, p < 0.001), head circumference (- 0.346, p < 0.002), and gestational age (r = - 0.612, p < 0.001).Conclusions: Our findings demonstrate an increase in adipokine levels in the cord blood of preterm newborn infants exposed to maternal hypertension. What is Known: • Clinical evidence suggests that concentration of the serum adipokines may be affected by risk of hypertension in both adults and pregnant women. • Maternal profile as hypertension alters intrauterine environment and could affect the function of fetal metabolism, impairing fetal growth. What is New: • Gestational hypertension modifies the adipokine profile, with higher rates already present at birth in cord blood samples. • Within the hypertensive group and stratifying for gestation age, ghrelin concentrations were higher in SGA newborns, both in the moderate and late preterm, compared with AGA newborns.
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