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  • Review Article
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Metabolic and feeding adjustments during pregnancy

Nature Reviews Endocrinology volume 19, pages 564–580 (2023)Cite this article

Subjects

Abstract

Eating behaviours are determined by the integration of interoceptive and environmental inputs. During pregnancy, numerous physiological adaptations take place in the maternal organism to provide an adequate environment for embryonic growth. Among them, whole-body physiological remodelling directly influences eating patterns, commonly causing notable taste perception alterations, food aversions and cravings. Recurrent food cravings for and compulsive eating of highly palatable food can contribute to the development and maintenance of gestational overweight and obesity with potential adverse health consequences for the offspring. Although much is known about how maternal eating habits influence offspring health, the mechanisms that underlie changes in taste perception and food preference during pregnancy (which guide and promote feeding) are only just starting to be elucidated. Given the limited and diffuse understanding of the neurobiology of gestational eating patterns, the aim of this Review is to compile, integrate and discuss the research conducted on this topic in both experimental models and humans. This article sheds light on the mechanisms that drive changes in female feeding behaviours during distinct physiological states. Understanding these processes is crucial to improve gestational parent health and decrease the burden of metabolic and food-related diseases in future generations.

Key points

  • Pregnancy entails a profound remodelling of endocrine signals (ovarian and metabolic hormones) that drive a range of physiological adjustments to support the development of the embryo.

  • Pregnancy modifies the neurocircuitry of crucial brain regions implicated in homeostatic and hedonic feeding, including modifications in taste perception, appetite and motivation to overconsume reward-inducible highly palatable food (food cravings).

  • These neurological changes result in variations in maternal eating behaviours in both mice and humans.

  • Changes in feeding patterns, when uncontrolled and persistent, can cause pathological conditions such as maternal obesity and gestational diabetes mellitus that can cause deterioration in the health status of both gestational parent and infant.

  • The functional and molecular understanding of these gestational adjustments will be instrumental to design specific nutritional guidelines and target interventions to improve the health of gestational parents and infants.

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Fig. 1: Main physiological and metabolic adjustments during gestation.
Fig. 2: Hormonal level fluctuations during pregnancy in rodents and humans and their action on neural networks regulating feeding.
Fig. 3: Mechanisms underlying gestational feeding readjustments.

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Acknowledgements

The authors thank S. Ramírez (Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)) for conceptual discussions. R.H.-T. and M.C. acknowledge support from the CERCA Programme/Generalitat de Catalunya (to M.C.); Marie Skłodowska-Curie Action fellowship (H2020-MSCA-IF) NEUROPREG (grant agreement no. 891247; to R.H.-T.). This work was carried out in part at the Esther Koplowitz Centre.

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  1. Neuronal Control of Metabolism (NeuCoMe) Laboratory, Institut d′Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain

    Roberta Haddad-Tóvolli & Marc Claret

  2. CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain

    Marc Claret

  3. School of Medicine, Universitat de Barcelona, Barcelona, Spain

    Marc Claret

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Haddad-Tóvolli, R., Claret, M. Metabolic and feeding adjustments during pregnancy. Nat Rev Endocrinol 19, 564–580 (2023). https://doi.org/10.1038/s41574-023-00871-y

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