Pregnancies in Diabetes and Obesity: The Capacity-Load Model of Placental Adaptation.
Journal
Diabetes
ISSN: 1939-327X
Titre abrégé: Diabetes
Pays: United States
ID NLM: 0372763
Informations de publication
Date de publication:
04 2021
04 2021
Historique:
received:
02
11
2020
accepted:
19
01
2021
entrez:
20
3
2021
pubmed:
21
3
2021
medline:
24
8
2021
Statut:
ppublish
Résumé
Excess nutritional supply to the growing fetus, resulting from maternal diabetes and obesity, is associated with increased risks of fetal maldevelopment and adverse metabolic conditions in postnatal life. The placenta, interposed between mother and fetus, serves as the gateway between the two circulations and is usually considered to mediate maternal exposures to the fetus through a direct supply line. In this Perspective, however, we argue that the placenta is not an innocent bystander and mounts responses to fetal "signals of distress" to sustain its own adequate function and protect the fetus. We describe several types of protection that the placenta can offer the fetus against maternal metabolic perturbations and offer a theoretical model of how the placenta responds to the intrauterine environment in maternal diabetes and obesity to stabilize the fetal environment. Our approach supports growing calls for early screening and control of pregnancy metabolism to minimize harmful fetal outcomes.
Identifiants
pubmed: 33741605
pii: db20-1111
doi: 10.2337/db20-1111
pmc: PMC7980199
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
823-830Informations de copyright
© 2021 by the American Diabetes Association.
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