Sarcouncil Journal of Internal Medicine and Public Health

Abstract: Background: Leptin is a 16-kDa adipokine that is mainly secreted by adipose tissue and the placenta, which has been involved in the pathophysiology of gestational diabetes mellitus (GDM) and preeclampsia. Nevertheless, the longitudinal pattern of maternal leptin concentrations during trimesters and its independent relation to poor obstetric outcomes are not well defined as well as were The purpose of the study was to assess the relationship between serial maternal serum leptin levels and clinical outcomes in normal pregnancy, GDM, and preeclampsia. Methods: The study was a prospective cross-sectional comparative study conducted in a tertiary care hospital on 125 pregnant women who were divided into three groups: normal pregnancy (n = 42), GDM (n = 42), and preeclampsia (n = 41). Enzyme-linked immunosorbent assay (ELISA) was used to measure maternal serum leptin at every trimester and at birth. Furthermore, prospective data collection was done on demographic, clinical, and neonatal outcomes. Statistical tests were one-way ANOVA with Tukey HSD post-hoc tests, Pearson correlation, and binary logistic regression, which was adjusted by age, pre-pregnancy BMI, parity, and family history. Results: The GDM and preeclampsia groups had a significant increase in maternal serum leptin levels in all trimesters compared to the normal pregnancy group (p < 0.001). The leptin levels in the third trimester were 48.6 ± 16.8 ng/ml in GDM, 52.4 + 18.2 ng/ml in preeclampsia and 28.3 + 10.1 ng/ml in normal pregnancy (F = 28.47, p < 0.001) where The results of this study revealed the following firstly The preeclampsia group had the highest leptin levels (56.8 ± 20.6 ng/ml) at delivery, seconadlly significantly higher than the GDM group (42.3 ± 15.4 ng/ml) and normal pregnancy groups (25.1 ± 9.8 ng/ml, p < 0.001) also we found in our study Placental leptin MRNA expression was increased in preeclampsia (2.14 ± 0.72 relative fold change) compared to GDM (1.56 ± 0.48) and normal pregnancy (1.00 ± 0.32, p < 0.001) where along with based on binary logistic regression, higher level of third-trimester leptin (10 ng/ml) This statement refers to the value found in the third trimester and the correlation between the relationship and an increased risk of preeclampsia. was independently associated with increased odds of preeclampsia (adjusted OR = 2.32, 95% CI: 1.483.63, p < 0.001), GDM (adjusted OR = 1.98, 95% CI: 1.303.01, p = 0.001). Conclusion: The levels of maternal serum leptin in GDM and preeclampsia are raised significantly and independently and have different longitudinal relationships depending on the pathophysiology involved- metabolic dysregulation mainly in GDM and overproduction by placental hypoxia in preeclampsia. An increase in maternal third-trimester leptin is related independently to inferior maternal and neonatal outcomes, which can be used as a complementary biomarker to classify the risk in obstetric care. Future multicenter-based studies are justified to confirm the efficacy of the prediction models that are based on leptin and to determine clinically practical thresholds.