Maternal-fetal metabolism in normal pregnancy and preeclampsia

被引:46
作者
von Versen-Hoeynck, Frauke Martha
Powers, Robert William
机构
[1] Univ Pittsburgh, Sch Med, Dept Obstet Gynecol & Reprod Sci, Pittsburgh, PA 15213 USA
[2] Univ Pittsburgh, Sch Med, Magee Womens Res Inst, Pittsburgh, PA 15213 USA
[3] Univ Aachen, Rhein Westfal TH Aachen, Dept Obstet & Gynecol, D-5100 Aachen, Germany
来源
FRONTIERS IN BIOSCIENCE-LANDMARK | 2007年 / 12卷
关键词
pregnancy; preeclampsia; carbohydrate; lipid; amino acid; metabolism; transport; placenta; review;
D O I
10.2741/2247
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
摘要
Adaptation to pregnancy in humans involves major anatomic, physiologic and metabolic changes in the mother in order to support and provide for the nutritional and metabolic needs of the growing conceptus. Metabolically, pregnancy is marked by several important and dynamic adjustments including increased insulin resistance, hyperlipidemia and changes in protein and amino acid metabolism. In general, these metabolic adaptations serve to increase nutrient availability for the benefit of the growing fetal-placental unit. Interestingly, the pregnancy complication preeclampsia is recognized to evidence biologic exaggerations of these normal metabolic adaptations of pregnancy. Specifically, preeclampsia is associated with increased insulin resistance, hypertriglyceridemia, high circulating free fatty acids, low high-density lipoprotein particles, and high maternal and fetal plasma amino acid concentrations. These metabolic alterations may contribute to the pathophysiology of the syndrome and may also influence fetal growth. The focus of this review will be to summarize the normal metabolic adaptations, transport and utilization of carbohydrates, lipids and amino acids that occur during pregnancy. Furthermore, we will review the differences in carbohydrate, lipid and amino acid metabolism in pregnancies complicated by preeclampsia in comparison to uncomplicated pregnancies.
引用
收藏
页码:2457 / 2470
页数:14
相关论文
共 169 条
[141]   AN ULTRASTRUCTURAL-STUDY OF UTEROPLACENTAL SPIRAL ARTERIES IN HYPERTENSIVE AND NORMOTENSIVE PREGNANCY AND FETAL GROWTH-RETARDATION [J].
SHEPPARD, BL ;
BONNAR, J .
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 1981, 88 (07) :695-705
[142]  
Shibata E, 2006, J SOC GYNECOL INVEST, V13, p77A
[143]   Free fatty acids, insulin resistance, and pregnancy [J].
Eyal Sivan ;
Guenther Boden .
Current Diabetes Reports, 2003, 3 (4) :319-322
[144]   Hypertension in pregnancy - A manifestation of the insulin resistance syndrome? [J].
Solomon, CG ;
Seely, EW .
HYPERTENSION, 2001, 37 (02) :232-239
[145]   Higher cholesterol and insulin levels in pregnancy are associated with increased risk for pregnancy-induced hypertension [J].
Solomon, CG ;
Carroll, JS ;
Okamura, K ;
Graves, SW ;
Seely, EW .
AMERICAN JOURNAL OF HYPERTENSION, 1999, 12 (03) :276-282
[146]   Elevated second-trimester serum homocyst(e)ine levels and subsequent risk of preeclampsia [J].
Sorensen, TK ;
Malinow, MR ;
Williams, MA ;
King, IB ;
Luthy, DA .
GYNECOLOGIC AND OBSTETRIC INVESTIGATION, 1999, 48 (02) :98-103
[147]   L-arginine transport across the basal plasma membrane of the syncytiotrophoblast of the human placenta from normal and preeclamptic pregnancies [J].
Speake, PF ;
Glazier, JD ;
Ayuk, PTY ;
Reade, M ;
Sibley, CP ;
D'Souza, SW .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2003, 88 (09) :4287-4292
[148]  
THOMPSON GN, 1992, EUR J CLIN NUTR, V46, P411
[149]   Regulation of uterine and umbilical amino acid uptakes by maternal amino acid concentrations [J].
Thureen, PJ ;
Anderson, SM ;
Hay, WW .
AMERICAN JOURNAL OF PHYSIOLOGY-REGULATORY INTEGRATIVE AND COMPARATIVE PHYSIOLOGY, 2000, 279 (03) :R849-R859
[150]   Elevated C-reactive protein levels during first trimester of pregnancy are indicative of preeclampsia and intrauterine growth restriction [J].
Tjoa, ML ;
van Vugt, JMG ;
Go, ATJJ ;
Blankenstein, MA ;
Oudejans, CBM ;
van Wijk, IJ .
JOURNAL OF REPRODUCTIVE IMMUNOLOGY, 2003, 59 (01) :29-37