Alterations in infant adipokine concentrations in the first postnatal week with exposure to diabetes in pregnancy
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Updated: May 21, 2025
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Published on: May 17, 2024
Caroline G Borden1, Veronika Shabanova1, Sarah N Taylor1
1Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA.
Insights
Neonatal energy metabolism hormones like leptin and resistin are affected by maternal diabetes and prematurity in the first week of life, potentially impacting developmental programming.
Area of Science:
- Neonatal physiology
- Endocrinology
- Metabolic programming
Background:
- Early postnatal life is a critical window for metabolic programming.
- Maternal diabetes and prematurity are significant factors influencing neonatal outcomes.
- Understanding neonatal energy metabolism hormones is crucial for assessing early development.
Purpose of the Study:
- To characterize changes in key neonatal energy metabolism hormones during the first postnatal week.
- To investigate the influence of maternal diabetes and infant prematurity on these hormonal changes.
Main Methods:
- Prospective cohort study of 106 term and preterm infants.
- Measurement of leptin, adiponectin, insulin, resistin, and ghrelin in cord and infant blood.
- Analysis using linear mixed effects regression to model hormone concentration changes over time.
Main Results:
- Infants exposed to maternal diabetes had higher leptin and resistin, and lower ghrelin.
- Preterm infants exhibited lower adiponectin levels compared to term infants.
- Insulin levels showed variations influenced by both maternal diabetes and prematurity.
Conclusions:
- Neonatal hormone concentrations are significantly influenced by maternal diabetes and prematurity.
- Early postnatal alterations in energy metabolism hormones may indicate changes in developmental programming.
- These hormonal shifts may have lasting effects in the early postnatal period.
Objective:
Characterize changes in neonatal energy metabolism hormones in first postnatal week.
Study Design:
Concentrations of leptin, adiponectin, insulin, resistin, and ghrelin were measured in cord and infant blood collected in the first postnatal week in a prospective cohort of term and preterm infants. Change over time in each hormone was modeled using linear mixed effects regression.
Result:
Among 106 infants, 65 (61%) were preterm and 44 (42%) were exposed to diabetes (DM) in pregnancy. DM group had higher leptin [between group difference β 2.5 (95%CI: 1.72-3.70)] and resistin [β 1.5 (95%CI:1.14, 1.92)] and lower ghrelin [β 0.49] [95%CI: (0.32-0.76)] versus non-DM group. Preterm infants had lower adiponectin [β 0.80 (95%CI: 0.67-0.96)] versus term group. Insulin varied by DM and prematurity (interaction-term p value < 0.05).
Conclusion:
In this cohort, hormone concentrations varied by DM and prematurity. Early alterations in energy metabolism hormones may reflect changes in developmental programming which persist in the early postnatal period.
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