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Association Between Relative Cord Hyperleptinemia and Offspring Outcomes in Pregnant Women With Overweight or Obesity

Jincy Immanuel1,2, Stephy Chirayath2, Jürgen Harreiter3,4

  • 1School of Medicine, Western Sydney University, Sydney, Australia.

Pediatric Obesity
|August 21, 2026
PubMed

Insights

High umbilical cord leptin relative to fat mass in infants born to mothers with obesity was linked to lower offspring BMI in males. This finding suggests a potential early indicator for metabolic health in male infants.

Area of Science:

  • Endocrinology
  • Pediatrics
  • Maternal Health

Background:

  • Maternal obesity is associated with increased umbilical cord leptin levels in infants.
  • The significance of the cord leptin-to-fat mass ratio in relation to infant outcomes remains under investigation.

Purpose of the Study:

  • To test the hypothesis that a high cord leptin-to-fat mass ratio is associated with adverse birth and early childhood outcomes.
  • To investigate sex-specific associations between cord leptin-to-fat mass ratio and neonatal and early childhood anthropometrics.

Main Methods:

  • Secondary analysis of the DALI trial cohort (n=323 infants).
  • Cord leptin-to-fat mass ratios categorized into tertiles (top, middle, low).
  • Comparison of neonatal outcomes and offspring BMI z-scores between top and low tertile groups, stratified by sex.

Main Results:

  • Female infants had higher cord leptin, fat mass percentage, and leptin-to-fat mass ratio compared to males.
  • Male infants in the top tertile group exhibited an elevated C-peptide-to-glucose ratio.
  • Infants in the top tertile group (particularly males) showed lower birthweight, fat mass percentage, and BMI z-scores at age 1 compared to the low tertile group.

Conclusions:

  • Relative cord hyperleptinaemia (high leptin for fat mass) is associated with reduced offspring BMI in male infants.
  • These findings suggest a potential sex-specific role of early-life leptin exposure in offspring adiposity trajectories.
Abstract

Keywords:
childhood adipositycord leptinfat masspregnancy

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