Cord Blood Leptin Levels and Anthropometric Indices in Virally Suppressed HIV-Positive and HIV-Negative Mother–Singleton Newborn Pairs: A Comparative Analysis

Abstract

Background: Despite the remarkable success of prevention of mother-to-child transmission interventions, in utero human  immunodeficiency virus (HIV) exposure remains associated with increased morbidity and mortality. This has been linked to adverse  anthropometric outcomes, and understanding the underlying mechanisms is crucial for designing effective interventions to improve  health outcomes of HIV‑exposed infants. Aim: This cross-sectional study compared the relationship between cord blood leptin levels and  anthropometric indices in virally suppressed HIV-positive and HIV-negative mother–singleton newborn pairs at NAUTH from January to  August 2023. 

Methods: Mother–newborn pairs were recruited using stratified random sampling. Data on sociodemographic, obstetric, and anthropometric indices and other medical variables were collected. Cord blood leptin levels were measured using an Elabscience®  ELISA kit. Data were analyzed with SPSS version 22, with P < 0.05 considered significant. 

Results: Each group consists of 65 mother– newborn pairs. No significant differences were found in age, education, marital status, or social class between groups. Approximately  95% of the HIV-positive mothers were on Dolutegravir-based regimen. HIV-positive mothers had a significantly lower median third  trimester weight gain rate (P = 0.001), intrapartum BMI (P = 0.030), and mean mid-arm circumference (0.017). HIV‑exposed newborns had  a significantly lower mean birth weight (p‑0.002), birth weight-for-gestational age (GA) percentile and Z-scores (P < 0.001), ponderal index (P = 0.002), mid‑arm/occipitofrontal circumference (OFC) ratio (P < 0.001), and OFC-for-GA Z-score (P = 0.004). HIV‑exposed  newborns also had significantly lower cord blood leptin levels (P = 0.012), with leptin showing moderate and weak positive correlations  with birth and maternal anthropometric indices, respectively. Dolutegravir exposure had no effect on cord blood leptin levels.   

Conclusion: HIV‑exposed neonates significantly had lower cord blood leptin levels and adverse anthropometric outcomes. Leptin levels  correlated positively with neonatal and maternal anthropometric indices. Further research is needed to tailor interventions for improving  outcomes in HIV‑exposed infants.