The Study Of Relationship Between Leptin, Cortisol And Fetal Growth Restriction

Fetal growth restriction (FGR) is also named intrauterine growthretardation (IUGR), It is a major complicating disease in perinatal period, it's perinatal neoborn death rate is 4-6 times that of normal pregnancy neborn. If living, The FGR fetus may be observed that the intelligence and physique development is delayed, the susceptibility of metabolize unbalanced syndrome will increased markedly till the adults. Fetal growth restriction impact the quality of the population severely. But the common accepted therapy is not founded, so its prevention and treatment have become the very important question for discussion. The pathogeny of fetal growth restriction is not defined undoubtedly. Therefore, the research of pathogenesis of FGR is indispensable in finding the effective measurement, interdicting the pathogen's physical course and improving the fetal growth. The pathogeny is incisive key point in this research.Up to present, the pathogenic mechanism about fetal growth restriction has developed in some extent. It is reported that the leptin as a intermedium between neurosecretion system and fat cells, may participate in regulating the fetal nutrition and growth. Cortisol play an important role in adjusting the neonatal growth. One hand, cortisol may promote the organ maturation by spurring the cell polarization. Another hand, it restrain the growth of fetal organize by restraining the cell multiplication. The increase of serum leptin in the pregnancy woman with FGR may be the pathogenesis of fetal growth restriction. The relation between leptin, cortisol and FGR, the cooperation between leptin and cortisol in regulating the fetal upgrowth and development may provide further theoretical evidence, and bring forward the new point of view in the diagnosis and treatment in fetal growth restriction.Objective The purpose of this study was to analyze the relationshipsbetween leptin , cortisol in maternal blood and cord blood with fetal growth restriction. And to explore the effects of leptin and cortisol on fetal growth and development.Methods We collect maternal blood before the onset of delivery from 48 healthy cesarean full-term deliveries and cord venous blood immediately after birth. All subjects were categorived as FGR group(23cases) and AGA group (25 cases) according to birth weight. Leptin and cortisol concentrations were measured by RIA, we analyzed the relationships between leptin and cortisol, respectively, with pregnant correlated factors such as birth weight(BW), placental weight, fetal gender and so on. Furthermore, the correlation between leptin and cortisol was discussed.Results1 The maternal leptin of the two groups was very significantly higher than cord leptin (FGR group: 8.17±1.98μg/L vs 1.06±0.25μg/L ; AGA group:8.92±1.90μg/L vs 6.31±0.68μg/L) (P﹤0.05)and not correlated with birth weight and placental weight(P>0.05).2 The leptin levels in cord blood were significant different(P﹤0.01), Among the two groups, The leptin levels in cord blood in FGR group is higher than that in AGA group. The cord blood leptin levels were markedly negatively correlated with birth weight and placental weight(P﹤0.01).3 The maternal cortisol of the two groups was very significantly higher than cord cortisol﹝FGR group: 882.89±107.04μg/L vs 256.84±36.71μg/L (P﹤0.01); AGA group: 542.64±114.95μg/L vs 140.02±30.77μg/L(P﹤0.05)﹞4 Among the two groups, The cortisol levels in maternal blood or in cord blood were significant different. The cortisol levels in maternal blood in FGR group were higher than that in AGA group (P﹤0.01).The cord blood leptin levels in FGR group were higher than that in AGA group. (P﹤0.05).5 The maternal blood and cord blood leptin levels both were markedlynegatively correlated with birth weight and placental weight(P﹤0.01﹑P﹤0.05)6 . There were no significant difference in the maternal blood leptin, the maternal blood cortisol, The cord blood leptin and the cord blood cortisol among the masculine fetus group and the female fetus group. (P>0.05) 7 No correlation existed between the maternal blood leptin and the maternal blood cortisol (P>0.05); Negative correlation was shown between the maternal blood leptin and the maternal blood cortisol (P﹤0.05) Conclusion1 Maternal leptin levels are not correlated to fetal birth weight. So, to monitor maternal leptin can not predict fetal birth weight during pregnancy.2 Serum cortisol concentration show negative correlation with fetal birth weight and placental weight (r=一0.38 P<0.05 ),It show that serum cortisol level were possible cause of FGR,and cortisol may have induced FGR by influencing placental.3 The leptin and cortisol levels in cord blood are closely correlated with fetal growth and development, and they may predict the fetal birth weight. So, they can serve as a criterion forprediction of fetus birth weight4 There is no significant difference in the leptin and cortisol levels between the masculine fetus group and the female fetus group.5 Negative correlation was shown between the maternal blood leptin and the maternal blood cortisol. They might take part in the occurrence and development of FGR, and cooperate with each other in regulate fetal growth and development.