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ENDOCRINOLOGY IN PREGNANCY: Targeting metabolic health promotion to optimise maternal and offspring health.
McLennan, Niamh-Maire; Hazlehurst, Jonathan; Thangaratinam, Shakila; Reynolds, Rebecca M.
  • McLennan NM; MRC Centre for Reproductive Health, University of Edinburgh, Queen's Medical Research Institute, Edinburgh, UK.
  • Hazlehurst J; Department of Diabetes and Endocrinology, University Hospital Birmingham Foundation Trust, Birmingham, UK.
  • Thangaratinam S; WHO Collaborating Centre for Women's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.
  • Reynolds RM; Birmingham Women's and Children's NHS Trust, Birmingham, UK.
Eur J Endocrinol ; 186(6): R113-R126, 2022 Apr 29.
Article in English | MEDLINE | ID: covidwho-1833756
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.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Diabetes, Gestational / Diabetes Mellitus, Type 2 / Gestational Weight Gain / COVID-19 Type of study: Cohort study / Prognostic study Limits: Female / Humans / Infant / Pregnancy Language: English Journal: Eur J Endocrinol Journal subject: Endocrinology Year: 2022 Document Type: Article Affiliation country: EJE-21-1046

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Diabetes, Gestational / Diabetes Mellitus, Type 2 / Gestational Weight Gain / COVID-19 Type of study: Cohort study / Prognostic study Limits: Female / Humans / Infant / Pregnancy Language: English Journal: Eur J Endocrinol Journal subject: Endocrinology Year: 2022 Document Type: Article Affiliation country: EJE-21-1046