Castillo-Castrejon Marisol, Powell Theresa L
Division of Reproductive Sciences, Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.
Department of Pediatrics, Section of Neonatology, University of Colorado, Aurora, CO, United States.
Front Endocrinol (Lausanne). 2017 Nov 7;8:306. doi: 10.3389/fendo.2017.00306. eCollection 2017.
Maternal obesity during pregnancy is rising and is associated with increased risk of developing gestational diabetes mellitus (GDM), defined as glucose intolerance first diagnosed in pregnancy (1). Fetal growth is determined by the maternal nutrient supply and placental nutrient transfer capacity. GDM-complicated pregnancies are more likely to be complicated by fetal overgrowth or excess adipose deposition . Infants born from GDM mothers have an increased risk of developing cardiovascular and metabolic disorders later in life. Diverse factors, such as ethnicity, age, fetal sex, clinical treatment for glycemic control, gestational weight gain, and body mass index among others, represent a challenge for studying underlying mechanisms in GDM subjects. Determining the individual roles of glucose intolerance, obesity, and other factors on placental function and fetal growth remains a challenge. This review provides an overview of changes in placental macronutrient transport observed in human pregnancies complicated by GDM. Improved knowledge and understanding of the alterations in placenta function that lead to pathological fetal growth will allow for development of new therapeutic interventions and treatments to improve pregnancy outcomes and lifelong health for the mother and her children.
孕期母体肥胖现象正在增加,且与妊娠期糖尿病(GDM)患病风险增加相关,妊娠期糖尿病被定义为首次在孕期诊断出的葡萄糖不耐受(1)。胎儿生长由母体营养供应和胎盘营养转运能力决定。GDM合并妊娠更易并发胎儿过度生长或脂肪沉积过多。GDM母亲所生婴儿日后患心血管和代谢紊乱疾病的风险增加。种族、年龄、胎儿性别、血糖控制的临床治疗、孕期体重增加及体重指数等多种因素,给研究GDM患者的潜在发病机制带来了挑战。确定葡萄糖不耐受、肥胖及其他因素对胎盘功能和胎儿生长的个体作用仍是一项挑战。本综述概述了在并发GDM的人类妊娠中观察到的胎盘常量营养素转运变化。更好地了解导致胎儿病理性生长的胎盘功能改变,将有助于开发新的治疗干预措施,以改善妊娠结局,并增进母亲及其子女的终身健康。