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Placental hormones and the control of maternal metabolism and fetal growth

Newbern, Dorothee; Freemark, Michael

Current Opinion in Endocrinology & Diabetes and Obesity: December 2011 - Volume 18 - Issue 6 - p 409–416
doi: 10.1097/MED.0b013e32834c800d
Reproductive endocrinology: Edited by Wendy Kuohung
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Purpose of review To examine the roles of the placental and pituitary hormones in the control of maternal metabolism and fetal growth.

Recent findings In addition to promoting growth of maternal tissues, placental growth hormone (GH-V) induces maternal insulin resistance and thereby facilitates the mobilization of maternal nutrients for fetal growth. Human placental lactogen (hPL) and prolactin increase maternal food intake by induction of central leptin resistance and promote maternal beta-cell expansion and insulin production to defend against the development of gestational diabetes mellitus. The effects of the lactogens are mediated by diverse signaling pathways and are potentiated by glucose. Pathologic conditions of pregnancy are associated with dysregulation of GH-V and hPL gene expression.

Summary The somatogenic and lactogenic hormones of the placenta and maternal pituitary gland integrate the metabolic adaptations of pregnancy with the demands of fetal and neonatal development. Dysregulation of placental growth hormone and/or placental lactogen in pathologic conditions of pregnancy may adversely impact fetal growth and postnatal metabolic function.

Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, USA

Correspondence to Dorothee Newbern, MD, Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, Duke University Medical Center, Box 102820, Durham, NC 27710, USA Tel: +1 919 668 4002; e-mail: dorothee.newbern@duke.edu

Copyright © 2011 Wolters Kluwer Health, Inc. All rights reserved.