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Effect of Birth Weight and Maternal Smoking on Cord Blood Leptin Concentrations of Full-Term and Preterm Newborns¹

Division of Endocrinology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School (C.S.M., V.G.K, J.S.F.), Boston, Massachusetts; Department of Pediatrics, University of Patras Medical School (A.V., N.G.B.), Patras, Greece

Address all correspondence and requests for reprints to: J.S. Flier, Division of Endocrinology, RN 325, Beth Israel Deaconess Medical Center, 99 Brookline Avenue, Boston, Massachusetts 02215. E-mail: jflier{at}bidmc.harvard.edu

Prematurity, maternal smoking, and low birth weight each result in neuroendocrine dysfunction and increased perinatal morbidity and mortality. Leptin, an adipocyte-secreted protein, has provided the first physiological link to the regulatory system controlling starvation-induced neuroendocrine changes in rodents. This study investigated whether leptin concentrations were detectable in cord blood of newborns, and assessed the effect of birth weight, prematurity, and maternal smoking on cord blood leptin concentrations. Fifty consecutively enrolled full-term and 12 preterm newborns born to mothers who smoked during pregnancy were compared to 50 full-term and 12 preterm newborns born to parents who were nonsmokers. RIA for leptin was performed using cord blood samples collected immediately after birth. Leptin concentrations were detectable in newborns and correlated positively with obesity (full-term, r = 0.30, P < 0.01; preterm, r = 0.47, P < 0.05). Maternal smoking during pregnancy was associated with decreased leptin concentrations in the cord blood of both full-term and preterm newborns. This effect was independent of obesity (full-term newborns: 5.25 ± 2.48 vs. 4.21 ± 2.71 ng/ml, P = 0.01) and was more pronounced in premature newborns (5.67 ± 3.6 vs. 2.46 ± 2.03, P = 0.02), and its magnitude in full-term newborns was directly related to the reported number of cigarettes the mothers of the full-term newborns smoked per day (r = -0.438, P < 0.001). Thus, low birth weight and maternal smoking are both associated with decreased leptin concentrations, and these effects are more pronounced in premature newborns. Future studies will be needed to determine whether administration of leptin might reverse the neuroendocrine dysfunction caused by maternal smoking.

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