Prenatal Lipid-Based Nutrient Supplements Increase Cord Leptin Concentration in Pregnant Women from Rural Burkina Faso

In developing countries, prenatal lipid-based nutrient supplements (LNSs) were shown to increase birth size; however, the mechanism of this effect remains unknown. Cord blood hormone concentrations are strongly associated with birth size. Therefore, we hypothesize that LNSs increase birth size through a change in the endocrine regulation of fetal development. We compared the effect of daily prenatal LNSs with multiple micronutrient tablets on cord blood hormone concentrations using a randomized, controlled design including 197 pregnant women from rural Burkina Faso. Insulin-like growth factors (IGF) I and II, their binding proteins IGFBP-1 and IGFBP-3, leptin, cortisol, and insulin were quantified in cord sera using immunoassays. LNS was associated with higher cord blood leptin mainly in primigravidae (+57%; P = 0.02) and women from the highest tertile of BM I at study inclusion (+41%; P = 0.02). We did not find any significant LNS effects on other measured cord hormones. The observed increase in cord leptin was associated with a significantly higher birth weight. Cord sera from small-for-gestational age newborns had lower median IGF-I (-9 mu g/L; P = 0.003), IGF-II (-79 mu g/L; P = 0.003), IGFBP-3 (-0.7 mu g/L; P = 0.007), and leptin (-1.0 mu g/L; P = 0.016) concentrations but higher median cortisol (+18 mu g/L; P = 0.037) concentrations compared with normally grown newborns. Prenatal LNS resulted in increased cord leptin concentrations in primigravidae and mothers with higher BM I at study inclusion. The elevated leptin concentrations could point toward a higher neonatal fat mass. J. Nutr. 143: 576-583, 2013.