Vagal Afferent Research Group, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
Robinson Research Institute, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
Obesity (Silver Spring). 2021 Nov;29(11):1813-1824. doi: 10.1002/oby.23224. Epub 2021 Oct 8.
A sufficient and balanced maternal diet is critical to meet the nutritional demands of the developing fetus and to facilitate deposition of fat reserves for lactation. Multiple adaptations occur to meet these energy requirements, including reductions in energy expenditure and increases in maternal food intake. The central nervous system plays a vital role in the regulation of food intake and energy homeostasis and responds to multiple metabolic and nutrient cues, including those arising from the gastrointestinal tract. This review describes the nutrient requirements of pregnancy and the impact of over- and undernutrition on the risk of pregnancy complications and adult disease in progeny. The central and peripheral regulation of food intake is then discussed, with particular emphasis on the adaptations that occur during pregnancy and the mechanisms that drive these changes, including the possible role of the pregnancy-associated hormones progesterone, estrogen, prolactin, and growth hormone. We identify the need for deeper mechanistic understanding of maternal adaptations, in particular, changes in gut-brain axis satiety signaling. Improved understanding of food intake regulation during pregnancy will provide a basis to inform strategies that prevent maternal under- or overnutrition, improve fetal health, and reduce the long-term health and economic burden for mothers and offspring.
充足且均衡的母体饮食对于满足胎儿发育的营养需求以及促进哺乳期脂肪储备非常重要。为了满足这些能量需求，会发生多种适应性变化，包括能量消耗减少和母体食物摄入量增加。中枢神经系统在调节食物摄入和能量平衡方面起着至关重要的作用，它对多种代谢和营养线索做出反应，包括来自胃肠道的线索。这篇综述描述了妊娠的营养需求以及营养过剩和不足对妊娠并发症和后代成年疾病风险的影响。然后讨论了食物摄入的中枢和外周调节，特别强调了妊娠期间发生的适应性变化以及驱动这些变化的机制，包括妊娠相关激素孕酮、雌激素、催乳素和生长激素可能发挥的作用。我们认识到需要更深入地了解母体适应性，特别是肠道-大脑轴饱腹感信号的变化。更好地了解妊娠期间的食物摄入调节将为制定策略提供基础，以防止母体营养不足或过剩，改善胎儿健康，并减轻母亲和后代的长期健康和经济负担。
