Target metabolic health promotion to optimize maternal and offspring health

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Eur J Endocrinol. April 1, 2022: EJE-21-1046. doi: 10.1530/EJE-21-1046. Online ahead of print.

ABSTRACT

There is an increase in maternal metabolic load due to the increase 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 during pregnancy in women at risk for metabolic dysfunction have demonstrated short-term improvements such as reduced gestational weight gain and reduced risk of gestational diabetes. It is not known whether these interventions lead to lasting improvements in the metabolic health of mother and baby. Pharmacological interventions have also shown benefits for both mother and baby during pregnancy, including improvements in glycemic control, reduced gestational weight gain, and a reduction in the number of large-for-gestational-age infants. However, there remains uncertainty about long-term outcomes for mother and child. Existing studies of interventions targeting metabolic health are limited to selected populations in the preconception and postpartum periods and lack follow-up beyond intervention delivery. The COVID-19 pandemic has refocused our attention on the effects poor maternal metabolic health plays in contributing to premature morbidity and mortality. There is an urgent need for strategies to accurately identify the increasing number of females and offspring at risk for long-term adverse metabolic health. Strategies focused on early identification and risk stratification using individualized risk scores in the pre- and interconception periods must be prioritized if we are to target and improve the metabolic health of women and their offspring who are most at risk.

PMID:35380983 | DOI:10.1530/EJE-21-1046

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