Abstract P321: Differential Leptin Levels are Associated with Hypertensive Disorders of Pregnancy and Adverse Pregnancy Outcomes

Abstract

During pregnancy, there are normal changes in maternal body weight and blood pressure that occur. Leptin is found in higher levels in obese individuals and has been demonstrated to have an inhibitory effect on myometrial contractility and to regulate blood pressure. Obesity in pregnancy is common and is associated with many complications, including hypertension in pregnancy, failed induction of labor (IOL), and intrauterine growth restriction. Our goal was to determine whether maternal leptin in a pregnant population is indicative of hypertensive disorders in pregnancy, dysfunctional labor, and whether there is a correlation between cord blood leptin and birthweight. We utilized a case control study with samples from the UI Maternal Fetal Tissue Bank (IRB#200910784). In order to analyze labor outcomes, 168 women were selected based on having undergone an IOL, including 54 failed IOL. Maternal/neonatal characteristics were collected from the medical record. Maternal and cord blood plasma leptin and total protein levels were measured using commercially available ELISAs. Bivariate analyses and logistic regression models were constructed using regression identified clinically-significant confounding variables. All variables were tested at significance level of 0.05. Women with hypertensive disorders in pregnancy, including pregnancy-induced hypertension and preeclampsia, had higher maternal leptin levels (14783 vs. 21440 pg/mL, p=0.049). Women with failed IOL also had higher maternal plasma leptin values (0.5 vs 0.3 leptin/protein [pg/ug], P = 0.01). Birthweight was also correlated with cord blood leptin (correlation coefficient 0.494 P < 0.001). These data suggest that maternal and fetal leptin levels are associated with the central mechanisms responsible for poor pregnancy outcomes.