Objective: We hypothesized that preeclamptic women with intrauterine growth restriction (IUGR) would have lower concentrations of leptin compared to women with normal fetal growth. Methods: A crosssectional study was performed in 20 cases of IUGR and 20 normal fetuses born to women diagnosed with preeclampsia. Blood samples were collected from mothers at term gestation and with fetal birth weight less than 2500 grams would categorized as IUGR. The subjects were recruited by consecutive sampling conducted in Hasan Sadikin Hospital and several network hospitals during the period of September-November 2012. Results: A significant difference (p = 0.015) in maternal serum leptin levels was found between IUGR (22.1 ng/ml) and normal fetuses (36.5 ng/ml). Serum levels of leptin in preeclamptic women with IUGR were lower than normal fetuses. Spearman correlation test between maternal serum leptin levels and birth weight in IUGR did not demonstrate a significant correlation, with r = -0.321 (p = 0.168). Conclusion: The maternal leptin concentrations in IUGR are lower than the normal fetus in preeclampsia cases, but there was not enough evidence to support that leptin is associated with birth weight in IUGR.
Cite this paper
Sumawan, H. , Purwara, B. and Krisnadi, S. (2013) Low maternal leptin levels in preeclamptic women with fetal growth restriction. Open Journal of Obstetrics and Gynecology, 3, 536-540. doi: 10.4236/ojog.2013.37096.
 Peleg, D., Kennedy, C.M. and Hunter, K.S. (1998) Intrauterine growth restriction: Identification and management. American Family Physician, 58, 453-460.
 de Onis, M., Blossner, M. and Villar, J. (1998) Levels and patterns of intrauterine growth retardation in developing countries. European Journal of Clinical Nutrition, 52, S5-S15.
 Indonesian Society of Maternal Fetal Medicine (2010) Management of intrauterine growth restriction. Guideline for the management of obstetric cases. 1st Edition, Indonesian Society of Maternal Fetal Medicine.
 Ahima, R.S. and Flier, J.S. (2000) Leptin. Annual Review of Physiology, 62,413-437.
doi:10. 1146/annurev. physiol. 62.1.413
 Yura, S., Itoh, H., Sagawa, N., et al. (2005) Role of premature leptin surge in obesity resulting from intrauterine undernutrition. Cell Metabolism, 1, 371-378.
 Hauguel-de Mouzon, S., Lepercq, J. and Catalano, P. (2006) The known and unknown of leptin in pregnancy. American Journal of Obstetrics & Gynecology, 194, 1537-1545. doi:10.1016/j.ajog. 2005.06.064
 McCarthy, J.F., Misra, D.N. and Roberts, J.M. (1999) Maternal plasma leptin is increased in preeclampsia and positively correlates with fetal cord concentration. American Journal of Obstetrics & Gynecology, 180, 731-736.
 Henson, M.C. and Castracane, V.D. (2006) Leptin in pregnancy: An update. Biology of Reproduction, 7, 218-229. doi:10.1095/biolreprod.105.045120
 Forhead, A.J. and Fowden, A.L. (2009) The hungry fetus? Role of leptin as a nutritional signal before birth. The Journal of Physiology, 587, 145-152.
 Catov, J.M., Patrick, T.E., Powers, R.W., et al. (2007) Maternal leptin across pregnancy in women with smallfor-gestational-age infants. American Journal of Obstetrics & Gynecology, 196, 558.e1-558.e8.
 Yildiz, L., Avci, B. and Ingec, M. (2002) Umbilical cord and maternal blood leptin concentrations in intrauterine growth retardation. Clinical Chemistry and Laboratory Medicine, 40, 1114-1117. doi:10.1515/cclm.2002.195
 Pighetti, M., Tommaselli, G.A., D’Elia, A., et al. (2003) Maternal serum and umbilical cord blood leptin concentrations with fetal growth restriction. Obstetrics & Gynecology, 102, 535-543.
 Tamura, T., Goldenberg, R.L., Johnston, K.E. and Cliver, S.P. (1998) Serum leptin concentrations during pregnancy and their relationship to fetal growth. Obstetrics & Gynecology, 91, 389-395.
 Resistantie, N. (2004) Perbandingan kadar leptin serum penderita preeklamsi dan kehamilan normal serta hubungannya dengan berat bayi lahir. Tesis, Universitas Padjadjaran, Bandung.
 Laivuori, H., Gallaher, M.J., Collura, L., et al. (2006) Relationships between maternal plasma leptin, placental leptin mRNA and protein in normal pregnancy, preeclampsia and intrauterine growth restriction without preeclampsia. Molecular Human Reproduction, 12, 551-556.
 Anim-Nyame, N., Sooranna, S.R., Steer, P.J. and Johnson, M.R. (2000) Longitudinal analysis of maternal plasma leptin concentrations during normal pregnancy and preeclampsia. Human Reproduction, 15, 2033-2036.
 Nezar, M.A., El-Baky, A.M., Soliman, O.A., et al. (2009) Endothelin-1 and leptin as markers of intrauterine growth restriction. The Indian Journal of Pediatrics, 76, 485-488.
 Considine, R.V., Sinha, M.K., Heiman, M.L., et al. (1996) Serum Immunoreactive-leptin concetration in normal weight and obese human. The New England Journal of Medicine, 334, 292-295.
 Mantziros, C.S. (1999) The role of leptin in human obesity and disease: A review of current evidence. Annals of Internal Medicine, 130, 671-680.
 Aizawa, A.M., Ogawa, Y., Masuaki, H., et al. (2000) Pathophysiological role of leptin in obesity related hypertension. The Journal of Clinical Investigation, 105, 1234-1252. doi:10.1172/JCI8341
 Hendler, I., Blackwell, S.C., Mehta, S.H., et al. (2005) The levels of leptin, adiponectin, and resistin in normal weight, overweight, and obese pregnant women with and without preeclampsia. American Journal of Obstetrics & Gynecology, 193, 979-983.
 Franco-Sena, A.B., Goldani, M.Z., Tavares do Carmo, M.G., Velásquez-Melendez, G. and Kac, G. (2010) Low leptin concentration in the first gestational trimester is associated with being born small for gestational age: Prospective study in Rio de Janeiro, Brazil. Neonatology, 97, 291-298. doi:10.1159/000255160
 Grisaru-Granovsky, S., Eitan, R., Algur, N., et al. (2003) Maternal and umbilical cord serum leptin concentrations in small-for-gestational-age and in appropriate for gestational age neonates: A maternal, fetal, or placental contribution? Biology of the Neonate, 84, 67-72.
 Varvarigou, A., Mantzoros, C.S. and Beratis, N.G. (1999) Cord blood leptin concentrations in relation to intrauterine growth. Clinical Endocrinology, 50, 177-183.
 Mise, H., Yura, S., Itoh, H., Nuamah, M.A., et al. (2007) The relationship between maternal plasma leptin levels and fetal growth restriction. Endocrine Journal, 54, 945-951. doi:10.1507/endocrj.K06-225
 Nakatsukasa, H., Masuyama, H., Takamoto, N. and Hiramatsu, Y. (2008) Circulating leptin and angiogenic factors in preeclampsia patients. Endocrine Journal, 55, 565-573. doi:10.1507/endocrj. K07E-136