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Background: We investigated whether leptin during the third trimester was associated with fetal growth compared to IGF-1. Methods: One hundred five appropriate-for-gestational-age (AGA) infants born at ≥28 weeks' gestation were enrolled. Cord blood leptin and insulin like growth factor 1 (IGF-1) were collected simultaneously during delivery. Enrolled infants were stratified into three groups according to GA as follows: 28 to < 34 weeks' gestation, very preterm (VP); 34 to < 37 weeks' gestation, late preterm (LP); and 37 to < 41 weeks' gestation, term. Birth weight (BW), birth length (BL), head circumference (HC), and body mass index (BMI) were measured. Leptin and IGF-1 were logarithmically transformed to normalize their distributions in multivariable regression analysis. Results: Sixty-eight infants out of 105 infants were preterm (32.5 ± 2.5 weeks), and 37 infants were term (37.8 ± 1.2 weeks). BW, BL, HC, and BMI were higher with increasing gestational age among the three gestational age-specific groups. With regard to hormones, leptin and IGF-1 were higher with increasing gestational age. Log cord serum leptin was independently associated with BW and BL in multivariable linear regression analysis, after adjustment for confounding factors including gestational age, delivery mode, multiple pregnancy, pregnancy induced hypertension, gestational diabetes mellitus, infant's BMI, and log cord blood IGF-1 levels. Conclusions: During the third trimester, cord serum leptin was independently associated with fetal growth. [ABSTRACT FROM AUTHOR]