Maternal obesity (Class I-III), gestational weight gain and maternal leptin levels during and after pregnancy: a prospective cohort study

Abstract

BackgroundMaternal obesity is accompanied by maternal and fetal complications during and after pregnancy. The risks seem to increase with degree of obesity. Leptin has been suggested to play a role in the development of obesity related complications. Whether maternal leptin levels differ between obese and morbidly obese women, during and after pregnancy, have to our knowledge not been previously described. Neither has the association between maternal leptin levels and gestational weight gain in obese women. The aim was to evaluate if maternal plasma leptin levels were associated with different degrees of maternal obesity and gestational weight gain.MethodsProspective cohort study including women categorized as obesity class I-III (n = 343) and divided into three gestational weight gain groups (n = 304). Maternal plasma leptin was measured at gestational week 15, 29 and 10 weeks postpartum. Maternal Body Mass Index (BMI) was calculated from early pregnancy weight. Gestational weight gain was calculated using maternal weight in delivery week minus early pregnancy weight. The mean value and confidence interval of plasma-leptin were analysed with a two-way ANOVA model. Interaction effect between BMI and gestational weight gain group was tested with a two-way ANOVA model.ResultsThe mean maternal leptin concentrations were significantly higher in women with obesity class III compared to women in obesity class I, at all times when plasma leptin were measured. The mean leptin concentrations were also significantly higher in women with obesity class II compared to women in obesity class I, except in gestational week 29. There was no difference in mean levels of plasma leptin between the gestational weight gain groups. No significant interaction between BMI and gestational weight gain group was found.ConclusionsPlasma leptin levels during and after pregnancy were associated with obesity class but not with degree of gestational weight gain. These results are in concordance with epidemiological findings where the risk of obstetric complications increases with increased maternal obesity class. The effect on obstetric outcome by degree of gestational weight gain is less pronounced than the adverse effects associated with maternal obesity.

Serum Concentration of Leptin in Pregnant Adolescents Correlated with Gestational Weight Gain, Postpartum Weight Retention and Newborn Weight/Length

“…A significant increase was found in the concentration of leptin during the last trimester of gestation, which could possibly owe itself to the mobilization of the sources of nutrients necessary for fetal growth, such as maternal adipose tissue [ 16 ]. In the present study, a leptin concentration above 20 ng/mL during the third trimester of gestation was related to a greater gestational weight gain, which coincides with a study by Lacroix et al [ 4 ] on a group of pregnant adults in Quebec, Canada, who also demonstrated an association between a higher leptin concentration and a greater gestational weight gain.…”

“…Furthermore, excessive maternal weight in adult women is related to an increase in the supply of energetic substrates in the mother–child dyad. However, it is unknown whether this mechanism is similar in pregnant adolescents, whose own personal growth and development has not yet come to an end and who in the majority of cases do not suffer from overweight or obesity [ 16 ].…”

“…It has been demonstrated that the serum concentration of leptin in pregnant women is correlated with their body fat and body weight [ 17 , 18 ]. Consequently, the serum concentration of leptin in adult women may be a predictor of postnatal weight retention, a possibility that has not been well explored in adolescent mothers [ 16 ].…”

Maternal plasma leptin levels in relation to the duration of the active phase of labor

“…In normal weight women leptin levels increase during gestation, peak in late second or early third trimester, decrease towards the end of the pregnancy and decline drastically postpartum, suggesting an important role during gestation . Obese pregnant women seem to have increased leptin levels compared with normal weight women, and morbidly obese women have the highest leptin values . Leptin has been reported to depress human myometrial contractility in vitro and to maintain uterine quiescence by inducing myometrial proliferation .…”

Lifestyle and pregnancy complications in polycystic ovary syndrome: The SCOPE cohort study

“…In the general population, multiple risk factors including advanced maternal age, certain ethnicities, obesity and excessive gestational weight gain (GWG), low socio‐economic status, parity, multiple pregnancy, pre‐existing medical conditions and high‐risk behaviours such as smoking and alcohol consumption, vitamin or nutrient deficiencies and low physical activity increase the risk for pregnancy complications. Comparatively, a healthy lifestyle reduces the risk .…”