الفهرس 
Pattern of birth weightOnly 14 pages are availabe for public view
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Abstract
Birth weight remains one of the most important measures of the health status of a population, and is a strong predictor of both neonatal mortality and morbidity. It can reflect fetal growth rates in the antenatal period. Fetal growth is a complex process that is influenced by multiple factors and has far-reaching health implications.
Leptin is a circulating polypeptide hormone expressed abundantly in the adipose tissue that regulates body weight and energy expenditure through a negative feedback signal between the adipose tissue and the hypothalamic centers of satiety.
Higher circulating fetal and maternal leptin levels and the presence of leptin and leptin receptors in fetal and placental tissues indicates that leptin is potentially a growth factor. However, the strong correlation between leptin and birth weight may merely reflect fetal adiposity and may not be related to fetal growth.
So, the aim of this work was to estimate cord blood leptin level in different patterns of birth weight (either small for gestational age, appropriate for gestational age and /or large for gestational age) to find the causal association between cord leptin concentration and birth weight.
The current study was conducted on 60 neonates, (20 neonates small for gestational age, 20 neonates appropriate for gestational age and 20 neonates large for gestational age).
All subjects were recruited from the Pediatric Department at Menoufia University Hospital and Shebien Elkom Teaching Hospital, Egypt from the period of 1st April 2018 till 25th of December 2018.
Inclusion criteria:
Both sexes included.
Age: after birth immediately.
AGA: A birth was considered to be appropriate for gestational age if the birth weight was between the 10th and 90th percentiles for the infant’s gestational age and sex
SGA: Infants that are at or below the 10th percentile in birth weight, for the infants of the same gestational age and sex.
LGA: Infants that are at or above the 90th percentile in birth weight, for the infants of the same gestational age and sex.
Exclusion criteria:
chromosomal anomalies and major congenital anomalies.
Smoker or alcoholic mother.
Birth asphyxia
Neonatal sepsis
Refusal of parental consent.
For all neonates the following procedures were performed:
Careful history taking regarding: Prenatal history, Natal History and Postnatal history.
Full clinical examination stressing on:
1-General examination
2-Systemic examination.
The following investigations were done:
Complete blood count (CBC).
C-reactive protein (CRP).
Measurement of cord blood leptin.
The main results of our study were:
- Birth weight and head circumference were significantly higher in LGA group than SGA and AGA groups, respectively.
- Length and BMI of neonates were significantly higher in LGA group than SGA and AGA groups, also length and BMI were higher in AGA group than SGA group.
- Highly significant difference between SGA, AGA and LGA groups regarding serum leptin (ng/ml). It was significantly higher in LGA (53.58±19.75ng/ml) than AGA (53.58±19.75ng/ml) and SGA (5.77±8.27ng/ml) groups (p<.05). Also, serum leptin was significantly higher in AGA group more than SGA group (P=0.014).
- Serum leptin level was not significantly correlated with gender of neonates in SGA, AGA and LGA groups
- Serum leptin level was significantly positively correlated with birth weight in SGA (P<0.01) and AGA groups (P=0.013) and no correlation in LGA group.
- Serum leptin level was significantly positively correlated with BMI in SGA group only(r =0.664, P=0.026) , and no correlation was found in AGA and LGA groups
- The best cut-off points for cord blood leptin level 13, and at that point, its sensitivity to diagnose the different patterns of birth weight is 24.6 %, and specificity is 40.0 %.