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Pregnancy-induced hypertension, preterm birth, and cord blood adipokine levels

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Abstract

Maternal hypertension may alter physiological parameters, dysregulating the release of hormones such as adipokines, thus influencing the fetal growth course. This study investigated whether hypertensive disorders of pregnancy alter cord blood adipokine levels and correlate these with anthropometric parameters in preterm infants. This is a prospective cohort study with pregnant women < 37-week gestation with and without hypertension and their offspring. Cord blood leptin, adiponectin, and ghrelin were analyzed by LUMINEX®. These adipokines were compared between the groups exposed or not to gestational hypertension using non-parametric statistical tests. The hypertensive pregnancies had significantly higher cord blood leptin (1.00 (IQR 0.67–1.20 ng/mL)) and adiponectin (18.52 (IQR 17.52–25.13 μg/mL)) levels than those without hypertension (0.07 (IQR 0.06–0.08 ng/mL) and 8.13 (IQR 6.50–8.68 μg/mL), respectively, p < 0.0001). The adipokine levels were higher in AGA and SGA infants in the exposed group for both moderate and late preterm. SGA had significantly higher ghrelin levels than the AGA infants. Ghrelin levels were negatively correlated with birth weight (r = − 0.613, p < 0.001), birth length (r = − 0.510, p < 0.001), head circumference (− 0.346, p < 0.002), and gestational age (r = − 0.612, p < 0.001).

Conclusions: Our findings demonstrate an increase in adipokine levels in the cord blood of preterm newborn infants exposed to maternal hypertension.

What is Known:

• Clinical evidence suggests that concentration of the serum adipokines may be affected by risk of hypertension in both adults and pregnant women.

• Maternal profile as hypertension alters intrauterine environment and could affect the function of fetal metabolism, impairing fetal growth.

What is New:

• Gestational hypertension modifies the adipokine profile, with higher rates already present at birth in cord blood samples.

• Within the hypertensive group and stratifying for gestation age, ghrelin concentrations were higher in SGA newborns, both in the moderate and late preterm, compared with AGA newborns.

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Abbreviations

AGA:

Appropriate for gestational age

SGA:

Small for gestational age

IQR:

Interquartile range

L/A:

Leptin/adiponectin ratio

SPSS:

The Statistical Package for the Social Sciences

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Funding

This study was financially supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico—CNPq, Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro—FAPERJ, and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—CAPES.

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Authors and Affiliations

  1. Clinical Research Unit, Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Av. Rui Barbosa, 716, Flamengo, Rio de Janeiro, RJ, 22250-020, Brazil

    Elizabeth Soares da Silva Magalhães, Maria Dalva Barbosa Baker Méio, Ana Carolina Carioca da Costa & Maria Elisabeth Lopes Moreira

  2. Department of Obstetrics, Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil

    Fernando Maia Peixoto-Filho

  3. Laboratory of Genomic Medicine, Department of Medical Genetics, Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil

    Sayonara Gonzalez

Authors
  1. Elizabeth Soares da Silva Magalhães
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  2. Maria Dalva Barbosa Baker Méio
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  3. Fernando Maia Peixoto-Filho
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  6. Maria Elisabeth Lopes Moreira
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Contributions

Elizabeth Soares da Silva Magalhães—study design, laboratory tests, statistical analysis, interpretation of research findings, and writing of the manuscript.

Maria Dalva Barbosa Baker Méio—study design, interpretation of the research findings, and writing of the manuscript.

Fernando Maia Peixoto-Filho—study design and writing of the manuscript.

Sayonara Gonzalez—study design and writing of the manuscript.

Ana Carolina Carioca da Costa—statistical analysis, interpretation of the study findings, and writing of the manuscript.

Maria Elisabeth Lopes Moreira—statistical analysis, interpretation of the study findings, and writing of the manuscript.

All Authors reviewed and gave final approval of the manuscript to submit for publication.

Corresponding author

Correspondence to Elizabeth Soares da Silva Magalhães.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics statement

Ethical approval for the study was obtained from Ethics Committee of the Institution (Number 00754612900005269). All procedures applied in this study were in accordance with the ethical standards from Ethics Committee of the Instituto Fernandes Figueira, FIOCRUZ.

Statement of informed consent

All mothers of the participating newborns read, understood, and signed a written informed consent.

Additional information

Communicated by Patrick Van Reempts

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Electronic supplementary material

ESM 1.

Perinatal and obstetric characteristics of the study population classified as moderate or late preterm infants. Values are expressed in median values or n (%). Comparison between groups: *p < 0.05 (DOCX 20 kb)

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Magalhães, E.S., Méio, M.D.B.B., Peixoto-Filho, F.M. et al. Pregnancy-induced hypertension, preterm birth, and cord blood adipokine levels. Eur J Pediatr 179, 1239–1246 (2020). https://doi.org/10.1007/s00431-020-03586-8

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  • DOI: https://doi.org/10.1007/s00431-020-03586-8

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