Human pregnancy induces considerable endocrine changes, which can be explained in part by the development of a new endocrine organ, the fetoplacental unit. Both the pregnant woman and the fetus adapt to this development with unique mechanisms, including alterations in maternal endocrine metabolism and hormonal feedback. As a result, the manifestation of endocrine diseases during pregnancy can be masked by this hypermetabolic state of pregnancy. Additional challenges arise when therapeutic needs of mother and fetus differ.
The Nature Reviews Endocrinology Focus issue on endocrine disorders in pregnancy includes specially commissioned Reviews, written by key opinion leaders in research and clinical practice. The Focus issue provides an overview of the pathophysiologies of different endocrine disorders that affect pregnancy and offspring outcomes, and discusses optimal diagnostic and management strategies. This collection of articles will be a welcome resource to researchers and practitioners alike.
Major endocrine disorders that women face during pregnancy include gestational diabetes mellitus, pre-existing type 1 diabetes mellitus, and thyroid and adrenal disorders. These topics are addressed in-depth in this Focus issue, which includes articles on the diagnosis, treatment and current controversies concerning optimal management approaches for these disorders. Given the gravity of the current obesity epidemic, the Focus issue will also address concerns about the effects of maternal obesity on pregnancy outcomes and infant obesity predisposition.
Image: Photodisc/Getty
RESEARCH HIGHLIGHTS
Endocrine disorders in pregnancy: Excessive maternal weight increases risk of infant overgrowth
Joana Osório
doi:10.1038/nrendo.2012.169
Nature Reviews Endocrinology 8, 624 (2012)
Endocrine disorders in pregnancy: Updated guidelines for the management of thyroid disorders in pregnancy
Carol Wilson
doi:10.1038/nrendo.2012.156
Nature Reviews Endocrinology 8, 624 (2012)
NEWS & VIEWS
Endocrine disorders in pregnancy: Stress responses in children after maternal glucocorticoids
John R. G. Challis
doi:10.1038/nrendo.2012.183
Nature Reviews Endocrinology 8, 629-630 (2012)
Endocrine disorders in pregnancy: Maternal obesity associated with neonatal death in Africa
Kathleen M. Rasmussen
doi:10.1038/nrendo.2012.181
Nature Reviews Endocrinology 8, 636-638 (2012)
REVIEWS
Gestational diabetes mellitus: risks and management during and after pregnancy
Thomas A. Buchanan, Anny H. Xiang & Kathleen A. Page
doi:10.1038/nrendo.2012.96
Nature Reviews Endocrinology 8, 639-649 (2012)
Gestational diabetes mellitus is one of the most common medical complications of pregnancy. The disease has important health implications for mother and child. This Review discusses current evidence for the importance of gestational diabetes mellitus, opportunities to reduce risk to mother and child and recommendations for clinical care.
Thyroid disorders in pregnancy
Alex Stagnaro-Green & Elizabeth Pearce
doi:10.1038/nrendo.2012.171
Nature Reviews Endocrinology 8, 650-658 (2012)
Pregnancy has a considerable effect on maternal thyroid function. In this Review, the pros and cons of universal screening for thyroid disease during pregnancy versus targeted case finding are discussed and the changes in thyroid function that occur during pregnancy are detailed. Accordingly, best-practice guidance for thyroid function testing and treatment of hypothyroidism, hyperthyroidism and thyroid autoimmune disease during pregnancy are provided. In addition, an algorithm for diagnosing, monitoring and treating women who develop postpartum thyroiditis is provided.
Managing type 1 diabetes mellitus in pregnancy—from planning to breastfeeding
Lene Ringholm, Elisabeth R. Mathiesen, Louise Kelstrup & Peter Damm
doi:10.1038/nrendo.2012.154
Nature Reviews Endocrinology 8, 659-667 (2012)
Pregnant women with type 1 diabetes mellitus have an increased risk of adverse pregnancy outcomes. This Review discusses the importance of preconception counselling and careful monitoring of glucose levels, and describes the use of insulin analogues to maintain tight glycaemic control from pregnancy planning through to breastfeeding.
Adrenal disorders in pregnancy
Silvia Monticone, Richard J. Auchus & William E. Rainey
doi:10.1038/nrendo.2012.155
Nature Reviews Endocrinology 8, 668-678 (2012)
Normal gestation is characterized by dramatic changes in a number of endocrine systems and particularly by activation of the renin–angiotensin–aldosterone system and the hypothalamic–pituitary–adrenal axis. This Review provides an overview of adrenal steroid metabolism during pregnancy, focusing on diagnosis and treatment of the most common fetal and maternal adrenal disorders.
Maternal adiposity—a determinant of perinatal and offspring outcomes?
Debbie A. Lawlor, Caroline Relton, Naveed Sattar & Scott M. Nelson
doi:10.1038/nrendo.2012.176
Nature Reviews Endocrinology 8, 679-688 (2012)
Experimental and animal data suggest that maternal obesity adversely affects offspring health, but effects in humans are less clear. This Review evaluates the evidence for a causal effect of maternal increased adiposity and gestational weight gain on perinatal and long-term offspring outcomes in humans and explores the possible contribution of epigenetic modifications.
© 2018 Macmillan Publishers Limited, part of Springer Nature. All Rights Reserved.
