Objective:

To evaluate the impact of maternal hyperglycemia, classified as diet-controlled (GDM-diet) or insulin-treated (GDM-insulin), on leptin, adiponectin, soluble leptin receptor, and derived indices across the maternal–fetal axis.

Key Findings:

• Maternal plasma leptin concentrations were significantly higher in the GDM-insulin group compared to non-GDM pregnancies, indicating a potential link to insulin resistance.
• The leptin-to-adiponectin ratio was elevated in GDM-insulin compared to GDM-diet, suggesting altered metabolic profiles.
• Adiponectin concentrations in cord blood were higher in GDM-diet neonates than in GDM-insulin, which may have implications for neonatal health.

Interpretation:

Higher maternal leptin, LAR, and FLI indicate leptin resistance, which disrupts placental nutrient transport and links maternal metabolic stress to fetal growth. This suggests a need for monitoring these markers in clinical practice.

Limitations:

• Small sample size may limit generalizability of the findings to broader populations.
• Retrospective design may introduce bias, affecting the reliability of the conclusions drawn.

Conclusion:

Tracking leptin, adiponectin, FLI, and LAR could guide postnatal strategies to mitigate long-term metabolic risks in future generations, emphasizing the importance of maternal health during pregnancy.