Decreased Adiponectin Levels in Early Pregnancy Are Associated with High Risk of Prematurity for African American Women

Abstract

The relationship of low maternal serum adiponectin levels with preterm delivery among a multi-ethnic group has not been extensively investigated. We examined ethnic differences in cytokine/adipokine profiles and whether they contribute to several adverse pregnancy outcomes, particularly preterm delivery. Data and samples were from a large prospective observational cohort (n = 1776) of young, generally healthy pregnant women (African American 36.4%, Hispanic 48.0%, Caucasian 15.6%). Serum cytokine/adipokine concentrations were measured at entry (mean gestational age of 16.83 weeks) using the Liminex xMap Technology. Multivariable analyses were performed. A significant difference in adiponectin level was observed among ethnic groups. African Americans had a decreased adiponectin and increased resistin levels compared to Hispanics and Caucasians (p < 0.05 to p < 0.0001 for each). Decreased adiponectin (lowest quartile) was positively associated with preterm delivery independent of usual risk factors (adjusted odds ratio (AOR) 1.46, 95% confidence interval (CI) 1.05, 2.04 for all preterm and AOR 1.84, 95% CI 1.07, 3.17 for early preterm births). The results were unchanged when women with preeclampsia were excluded. Similar results were observed in African Americans. Decreased adiponectin levels were not related to preterm birth in either Hispanics or Caucasians. Lower adiponectin levels were also significantly associated with an increased risk of developing gestational diabetes (AOR 1.72, 95% CI 1.05, 2.84) and preeclampsia (AOR 1.45, 95% CI 1.00, 2.14) in the whole cohort and in Caucasians. We did not find any consistent relationships between the other markers with outcome variables. Dysregulation in maternal adiponectin at early gestation is associated with an increased risk of preterm delivery. An ethnic difference in adiponectin levels may contribute to a higher preterm delivery rate in African American women.

Association Between Circulating Resistin Level and Preeclampsia: A Meta-Analysis

“…In the study of Bawah et al, a high circulating resistin (≥9.012 ng/ml) in the first trimester was associated with a higher risk of PE (odds ratio [OR]: 1.65, 95% CI: 1.3 to 2.11) after controlling of potential confounding factors including age, BMI, parity, and family histories of diabetes, hypertension, and PE 21 . However, in the other study by Lomakova et al, a high resistin (≥59.77 ng/ml) in the first or the second trimesters was not associated with the risk of PE (OR: 0.93, 95% CI: 0.62 to 1.40) after adjustment of age, parity, pre-pregnancy BMI, and cigarette smoking 33 . In view of the potential divergent results of the above two studies, large-scale prospective studies in the future are needed to determine if an elevated circulating resistin level is independently associated with the risk of PE in pregnant women.…”

“…An overview of the study characteristics is provided in Table 1 . Overall, 16 observational studies, included seven case-control studies 20 21 25 26 28 30 32 , five cross-sectional studies 18 24 27 29 31 , and four prospective studies 19 22 23 33 were available for the meta-analysis. These studies were conducted in China 20 26 , Norway 18 29 , Italy 27 , Korea 28 , the United Kingdom 19 , Denmark 30 , Turkey 31 , Venezuela 32 , Ghana 21 , United States 25 33 , Egypt 23 , Serbia 22 , and Mexico 24 , and published between 2005 and 2022.…”

“…Blood sampling was before the diagnosis of PE in five studies 19 21 22 30 33 , and after the diagnosis of PE in the other eleven studies 18 20 23 24 25 26 27 28 29 31 32 . The enzyme-linked immunosorbent assay was used to measure blood resistin in 11 studies 18 19 20 21 22 23 26 27 28 30 31 , while other methods such as the radioimmunoassay 29 , the multiplex microsphere analysis 24 25 32 , and the Luminex xMAP technology 33 were also used in the other studies. Maternal age and GA of blood sampling were matched between women with and without PE in all of the included studies, while BMI was matched in 11 studies 18 22 23 24 25 26 27 28 31 32 33 y.…”

“…The enzyme-linked immunosorbent assay was used to measure blood resistin in 11 studies 18 19 20 21 22 23 26 27 28 30 31 , while other methods such as the radioimmunoassay 29 , the multiplex microsphere analysis 24 25 32 , and the Luminex xMAP technology 33 were also used in the other studies. Maternal age and GA of blood sampling were matched between women with and without PE in all of the included studies, while BMI was matched in 11 studies 18 22 23 24 25 26 27 28 31 32 33 y. Overall, the studies incorporated in the analysis were awarded a score of seven or nine stars on the NOS, signifying a high level of study quality (refer to Table 2 ).…”

“…Nevertheless, investigations examining the correlation between blood resistin and PE have produced conflicting outcomes [17]. While certain studies have reported an increase in the circulating resistin levels of women with PE compared to those without the condition [18][19][20][21][22][23][24][25], others have failed to yield consistent findings [26][27][28][29][30][31][32][33]. Consequently, this study undertook a systematic review and meta-analysis to comprehensively assess the circulating resistin levels in women with PE.…”