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Review
. 2022 Apr 29;186(6):R113-R126.
doi: 10.1530/EJE-21-1046.

ENDOCRINOLOGY IN PREGNANCY: Targeting metabolic health promotion to optimise maternal and offspring health

Niamh-Maire McLennan  1 , Jonathan Hazlehurst  2 , Shakila Thangaratinam  3   4 , Rebecca M Reynolds  5
Affiliations
Review

ENDOCRINOLOGY IN PREGNANCY: Targeting metabolic health promotion to optimise maternal and offspring health

Niamh-Maire McLennan et al. Eur J Endocrinol. .

Abstract

There is an increase in maternal metabolic burden due to the rise in pregnancies complicated by obesity, gestational diabetes, type 2 diabetes and polycystic ovary syndrome. Metabolic dysfunction during pregnancy is associated with increased risks of long-term morbidity and mortality for women and their offspring. Lifestyle interventions in pregnancy in women at risk of metabolic dysfunction have demonstrated short-term improvements such as reduced gestational weight gain and lowered risk of gestational diabetes. It is not known whether these interventions lead to sustained improvements in the metabolic health of the mother and baby. Pharmacological interventions have also shown benefits for the mother and baby in pregnancy, including improvements in glycaemic control, reduction in gestational weight gain and reduction in large for gestational age infants; however, there remains uncertainty over long-term outcomes for mother and child. Existing studies on interventions targeting metabolic health are limited to selected populations in the preconception and postpartum periods and lack follow-up beyond delivery of the intervention. The COVID-19 pandemic has refocused our attention on the effects of maternal metabolic ill-health that play a role in contributing to premature morbidity and mortality. There is an urgent need for strategies to accurately identify the growing number of women and offspring at risk of long-term adverse metabolic health. Strategies which focus on early identification and risk stratification using individualised risk scores in the pre and inter-conception periods must take priority if we are to target and improve the metabolic health of women and their offspring who are at highest risk.

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Figures

Figure 1
Figure 1
Screening strategies for targeting metabolic health promotion.
Figure 2
Figure 2
Summary of interventions across the pre-, intra- and post- pregnancy periods, targeting metabolic health promotion.
See this image and copyright information in PMC

References

    1. Kanagalingam MG, Forouhi NG, Greer IA, Sattar N. Changes in booking body mass index over a decade: retrospective analysis from a Glasgow Maternity Hospital. BJOG 20051121431–1433. (10.1111/j.1471-0528.2005.00685.x) - DOI - PubMed
    1. Public Health England. Health of Women Before and During Pregnancy: Health Behaviours, Risk Factors and Inequalities. Public Health England, 2019.
    1. Egan AM, Vellinga A, Harreiter J, Simmons D, Desoye G, Corcoy R, Adelantado JM, Devlieger R, Van Assche A, Galjaard S.et al. Epidemiology of gestational diabetes mellitus according to IADPSG/WHO 2013 criteria among obese pregnant women in Europe. Diabetologia 2017601913–1921. (10.1007/s00125-017-4353-9) - DOI - PMC - PubMed
    1. Ma RCW, Schmidt MI, Tam WH, McIntyre HD, Catalano PM. Clinical management of pregnancy in the obese mother: before conception, during pregnancy, and post partum. Lancet: Diabetes and Endocrinology 201641037–1049. (10.1016/S2213-8587(1630278-9) - DOI - PMC - PubMed
    1. Murray SR, Reynolds RM. Short- and long-term outcomes of gestational diabetes and its treatment on fetal development. Prenatal Diagnosis 2020401085–1091. (10.1002/pd.5768) - DOI - PubMed