Plasma concentrations of leptin at mid-pregnancy are associated with gestational weight gain among pregnant women in Tanzania: a prospective cohort study.

Dongqing Wang, Anne Marie Darling, Chloe R McDonald, Nandita Perumal, Enju Liu, Molin Wang, Said Aboud, Willy Urassa, Andrea L Conroy, Kyla T Hayford, W Conrad Liles, Kevin C Kain, Wafaie W Fawzi

Journal: BMC pregnancy and childbirth 2022;21(1):675

PMID: 34615489

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Abstract

BACKGROUND

Gestational weight gain (GWG) has critical implications for maternal and child health. Inflammation and angiogenesis are implicated in various aspects of maternal metabolism that may play a role in gestational weight gain. The associations of inflammatory, angiogenic, and metabolic pathways with GWG are yet to be elucidated. This study evaluated associations between a panel of inflammatory, angiogenic, and metabolic proteins measured in mid-pregnancy and gestational weight gain.

METHODS

Pregnant women were enrolled from Dar es Salaam, Tanzania, between 2001 and 2004. The participants were enrolled at mid-pregnancy (12 to 27 weeks of gestation) and followed up until delivery. This analysis focused on a cohort of 1002 women who were primigravid, had singleton live births, had longitudinal measures of gestational weight, and whose mid-pregnancy plasma samples underwent analysis for 18 proteins.

RESULTS

Higher plasma concentrations of leptin (mean difference in GWG percent adequacy comparing highest with lowest quartiles: 10.24; 95% CI 3.31, 17.16; p-trend = 0.003) and chitinase-3-like protein-1 (CH3L1) (mean difference in GWG percent adequacy comparing highest with lowest quartiles: 7.02; 95% CI 0.31, 13.72; p-trend = 0.007) were associated with greater GWG in a dose-response pattern. Higher leptin concentrations were associated with a lower risk of inadequate GWG (risk ratio comparing highest with lowest quartiles: 0.77; 95% CI 0.65, 0.91; p-trend = 0.001) and a higher risk of excessive GWG (risk ratio comparing highest with lowest quartiles: 1.57; 95% CI 1.03, 2.39; p-trend = 0.03). Higher CH3L1 concentrations were associated with a higher risk of excessive GWG (p-trend = 0.007). The associations of leptin and CH3L1 with inadequate GWG were stronger during the second than the third trimester. The other 16 proteins examined were not significantly associated with GWG.

CONCLUSIONS

Mid-pregnancy plasma leptin concentrations may be associated with GWG and have clinical predictive utility in identifying women at a higher risk of inadequate or excessive gestational weight gain.

Address: Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, 02120, USA. [email protected].; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, 02120, USA.; Sandra Rotman Laboratories, University Health Network, Toronto, Ontario, Canada.; Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, MA, USA.; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.; Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.; Department of Pediatrics, Ryan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine, Indianapolis, Indiana, USA.; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.; Department of Medicine, University of Washington, Seattle, Washington, USA.; Department of Medicine, University of Toronto and University Health Network, Toronto, Ontario, Canada.; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, 02120, USA.; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.; Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.

DOI: 10.1186/s12884-021-04146-0

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MeSH Terms: Adult, Chitinase-3-Like Protein 1, Cohort Studies, Female, Gestational Weight Gain, Humans, Leptin, Pregnancy, Pregnancy Trimester, Second, Pregnancy Trimester, Third, Prospective Studies, Randomized Controlled Trials as Topic, Tanzania