Abstract overview:
• Abnormal fetal growth predisposes individuals to insulin resistance and metabolic disorders. • Preptin is a 34-amino acid peptide hormone, originating from proinsulin-like growth factor II and co-secreted with insulin from β pancreatic cells in response to glucose. • Preptin regulates metabolism by stimulating insulin secretion. • Circulating preptin is upregulated in hyperinsulinemia and states of insulin resistance. • Preptin is an important new marker for metabolic disorders. • Data on the role of preptin in intrauterine and early extrauterine growth and nutrition are scarce.

Aims and objectives:
A. To prospectively determine the concentrations of preptin in maternal serum, umbilical cord serum and early human milk. B. To correlate the above concentrations with fetal growth and a wide range of perinatal parameters.

Method:
• 5ml of antenatal maternal blood • 5 ml of blood drawn from the doubly clamped umbilical cord (fetal state) • 3 ml of breast milk on day 3-4 postpartum • Blood (maternal and umbilical) centrifuged, supernatant serum stored at -800C • Breast milk expressed with electric pump in the morning hours • Milk samples immediately centrifuged at -40C (1500g) for 20’ • Undernatant serum and supernatant fat stored separately at -80 0C • Preptin determination: by enzyme immunoassay method

Results:
Umbilical cord blood preptin levels were higher in the LGA, as compared to the IUGR group (p=0.001) and lower in the IUGR, as compared to the AGA group (p=0.011). In the whole study population breast milk preptin levels were higher than maternal serum and umbilical cord ones (p=0.0000, in all cases). In a multivariable analysis: • maternal serum preptin concentrations were independently associated with obesity (β co-efficient 1976, 95% CI 940- 3013, p<0.001). • cord blood preptin concentrations were independently associated with placental weight (β co-efficient 27.3, 95% CI 15.8-38.7, p<0.001) and independently associated with delivery mode (β co-efficient 1758, 95% CI 477-3040, p=0.008) in the whole study population.

Conclusion:
Umbilical cord blood preptin levels were higher in the LGA, as compared to the IUGR group (p=0.001) and lower in the IUGR, as compared to the AGA group (p=0.011). In the whole study population breast milk preptin levels were higher than maternal serum and umbilical cord ones (p=0.0000, in all cases). In a multivariable analysis: • maternal serum preptin concentrations were independently associated with obesity (β co-efficient 1976, 95% CI 940- 3013, p<0.001). • cord blood preptin concentrations were independently associated with placental weight (β co-efficient 27.3, 95% CI 15.8-38.7, p<0.001) and independently associated with delivery mode (β co-efficient 1758, 95% CI 477-3040, p=0.008) in the whole study population.