Obesity in pregnancy-Long-term effects on offspring hypothalamic-pituitary-adrenal axis and associations with placental cortisol metabolism: A systematic review.

Autor: Volqvartz T; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark., Andersen HHB; Department of Biomedicine, Pharmacology, Aarhus University, Aarhus, Denmark., Pedersen LH; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.; Department of Biomedicine, Pharmacology, Aarhus University, Aarhus, Denmark.; Department of Obstetrics and Gynaecology, Aarhus University Hospital, Aarhus, Denmark., Larsen A; Department of Biomedicine, Pharmacology, Aarhus University, Aarhus, Denmark.
Jazyk: angličtina
Zdroj: The European journal of neuroscience [Eur J Neurosci] 2023 Dec; Vol. 58 (11), pp. 4393-4422. Date of Electronic Publication: 2023 Nov 16.
DOI: 10.1111/ejn.16184
Abstrakt: Obesity, affecting one in three pregnant women worldwide, is not only a major obstetric risk factor. The resulting low-grade inflammation may have a long-term impact on the offspring's HPA axis through dysregulation of maternal, placental and fetal corticosteroid metabolism, and children born of obese mothers have increased risk of diabetes and cardiovascular disease. The long-term effects of maternal obesity on offspring neurodevelopment are, however, undetermined and could depend on the specific effects on placental and fetal cortisol metabolism. This systematic review evaluates how maternal obesity affects placental cortisol metabolism and the offspring's HPA axis. Pubmed, Embase and Scopus were searched for original studies on maternal BMI, obesity, and cortisol metabolism and transfer. Fifteen studies were included after the screening of 4556 identified records. Studies were small with heterogeneous exposures and outcomes. Two studies found that maternal obesity reduced placental HSD11β2 activity. In one study, umbilical cord blood cortisol levels were affected by maternal BMI. In three studies, an altered cortisol response was consistently seen among offspring in childhood (n = 2) or adulthood (n = 1). Maternal BMI was not associated with placental HSD11β1 or HSD11β2 mRNA expression, or placental HSD11β2 methylation. In conclusion, high maternal BMI is associated with reduced placental HSD11β2 activity and a dampened cortisol level among offspring, but the data is sparse. Further investigations are needed to clarify whether the HPA axis is affected by prenatal factors including maternal obesity and investigate if adverse effects can be ameliorated by optimising the intrauterine environment.
(© 2023 The Authors. European Journal of Neuroscience published by Federation of European Neuroscience Societies and John Wiley & Sons Ltd.)
Databáze: MEDLINE
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