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Cord Plasma Adiponectin: A 20-Fold Rise between 24 Weeks Gestation and Term

Hospital for Children and Adolescents (E.K., T.H., P.H., S.A.) and Department of Obstetrics and Gynecology (S.A.), Helsinki University Central Hospital, 00029 HUS Helsinki, Finland; and National Public Health Institute (E.K.), 00300 Helsinki, Finland

Address all correspondence and requests for reprints to: Eero Kajantie, M.D., National Public Health Institute, Mannerheimintie 166, 00300 Helsinki, Finland. E-mail: eero.kajantie{at}helsinki.fi.

Adiponectin is an adipocyte-derived hormone with profound insulin-sensitizing, antiinflammatory, and antiatherogenic effects. Apart from its obvious potential as a mediator of adult metabolic syndrome, adiponectin could have a significant role in regulating fetal growth.

We measured plasma adiponectin concentrations by ELISA in cord vein of 197 infants. Of them, 122 were born preterm (gestational age, 22–32 wk), and 75 at term (49 from a healthy and 26 from a diabetic pregnancy, with similar findings, and thus all data from term infants pooled).

Mean adiponectin concentrations increased from less than 1 µg/ml at 24 wk gestation to approximately 20 µg/ml at term. One week increase in gestational age corresponded in preterm infants to 43% increase (95% confidence interval 34–53%; P < 0.0001) in adiponectin and term infants to 21% increase (12–31%; P < 0.0001). In preterm infants, one unit increase in birth weight SD score corresponded to 42% increase (22–66%; P = 0.0001) in adiponectin, and females had 57% higher adiponectin concentrations (0–146%; P = 0.05) than males. These differences were not seen in term infants. Adiponectin levels were lower in preterm infants with recent (<12 h) exposure to maternal betamethasone but were unrelated to mode of delivery, preeclampsia, or impaired umbilical artery flow.

In conclusion, adiponectin concentrations in fetal circulation show a 20-fold rise between 24 wk gestation and term and, in preterm infants are associated with birth weight SD score, sex, and glucocorticoid exposure. Adiponectin may play an important role in regulating fetal growth and explaining its links to the metabolic syndrome and its consequences during adult life.

This work was supported by grants from the Finnish Heart Foundation, Finnish Medical Society Duodecim, Finska Läkaresällskapet, Foundation for Pediatric Research, Helsinki University Central Hospital Research Fund, Jalmari and Rauha Ahokas Foundation, Sigrid Jusélius Foundation, and Yrjö Jahnsson Foundation.

E.K. and T.H. contributed equally to this work.

Abbreviations: CI, Confidence interval; SDS, SD score.

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