434 - Negative social determinants of health: Association with adipokine levels during pregnancy

Saturday, April 29, 2023

3:30 PM – 6:00 PM ET

Poster Number: 434
Publication Number: 434.219

David Harary, Albert Einstein College of Medicine, Long Island City, NY, United States; Kerly Guerrero, The Children's Hospital at Montefiore, Bronx, NY, United States; Ayodele J. Akinyemi, Albert Einstein College of Medicine, Bronx, NY, United States; Natasha A. Chaudhari, Albert Einstein College of Medicine, Bronx, NY, United States; Xiu-Quan Du, Albert Einstein College of Medicine, Bronx, NY, United States; Maureen J. Charron, Albert Einstein College of Medicine, Bronx, NY, United States; Mamta Fuloria, The Children's Hospital at Montefiore, Mountain Lakes, NJ, United States

Presenting Author(s)

Natasha A. Chaudhari, B.S. (she/her/hers)

Medical Student
Albert Einstein College of Medicine
Bronx, New York, United States

Co-Author(s)

David Harary, MSc. (he/him/his)

Study Coordinator
Albert Einstein College of Medicine
Long Island City, New York, United States

Background: Pregnant people of color are at higher risk for pregnancy complications that lead to maternal and neonatal morbidity and mortality. Elevated adipokines, such as leptin and adiponectin, have been associated with increased insulin resistance. The effect of stressors related to social determinants of health (SDH) on adipokine levels during pregnancy is unclear.

Objective: To determine the effect of SDH-related stressors on adipokine levels in women residing in the Bronx, one of the nation’s poorest and most diverse urban counties that has long been burdened by health, housing, racial and environmental inequities.

Design/Methods: Pregnant individuals who delivered at Montefiore Medical Center in the Bronx, NY between 5/11-12/12/22 were enrolled. Study participants completed questionnaires related to household expenses, employment status and food and housing insecurity during the pandemic. Blood samples were collected at the time of enrollment. Plasma leptin and adiponectin levels were measured using ELISA assays. Clinical characteristics and maternal/neonatal outcomes were collected. Using SPSS 28, Chi-square tests or Fisher’s exact tests were used to assess associations between categorical variables and correlation analyses, t-tests, and ANOVA for continuous variables.

Results: 81 subjects participated and 76 completed questionnaires. Mean age of participants was 29.8±6.8 years and mean body mass index (BMI) at delivery was 34.3±7.8. 27.6% of the mothers had preeclampsia and 17.1% had gestational diabetes (GDM). Mean leptin and adiponectin levels were 52.8 ±40.0 ng/mL and 6.2±5.3 ng/mL, respectively. Black mothers had lower adiponectin levels compared to white mothers (p=0.014); there was no difference in leptin levels between the groups (p=0.902). There was a positive correlation between leptin, but not adiponectin, levels and pre-pregnancy BMI as well as BMI at delivery (p < 0.001). There was no association between leptin and adiponectin levels and GDM. Leptin, but not adiponectin, levels were negatively correlated with infant gestational age (p=0.019) and birthweight (p=0.07). Self-reported negative SDH such as food, housing and job insecurity were not associated with leptin or adipokine levels.

Conclusion(s): Black participants as well as those with elevated BMI may be at increased risk of developing insulin resistance. Importantly, higher leptin levels were associated with adverse neonatal outcomes, suggesting that mothers with an increased risk of developing insulin resistance may need closer monitoring during pregnancy.