Medizinische Universität Graz - Research portal
Selected Publication:
Schwarz, S.
Distinct placental hormone secretion and GDM risk in pregnancies with male vs female fetuses
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2023. pp. 81
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- Authors Med Uni Graz:
- Advisor:
- Hiden Ursula
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- Abstract:
- Background: The placenta is a fetal organ and a production site for various hormones and bioactive molecules that help to adapt the maternal organism to pregnancy in order to optimize the supply of the growing fetus, especially with glucose. Therefore, throughout normal pregnancy, insulin resistance develops. To avoid hyperglycemia, maternal blood glucose level is kept within the normal range by increasing β-cell mass and insulin secretion. Placenta derived factors are involved in this process. However, if this compensatory process is disrupted, GDM may develop. Recent studies have revealed that the development of GDM depends on fetal sex with a higher risk for women carrying a boy, suggesting that maternal metabolic adaption to pregnancy by fetal factors differs between pregnancies with boys vs pregnancies with girls. Objective: The aim of this study was to summarize and condense studies which investigate the role of placental derived bioactive factors in GDM and potential differences in depending on fetal sex in order to elucidate the mechanisms how the sex of a baby may modulate maternal GDM risk. Literature was analyzed for the molecules: estrogens, progesterone, hCG, hPL, pGH, PRL, APN, leptin, TNF-α, resistin, visfatin, apelin and AFABP. Methods: A comprehensive literature search was conducted to collect relevant data between 1972 and 2021. Results: The following molecules are reported to be dysregulated in GDM: hCG, APN, Leptin, TNF-α, Resistin, AFABP. GDM risk is increased in pregnancies with boys. Fetal sex differences in placenta derived factores are reported for hCG. For the other hormones, data are still inconsistent. Conclusion: Various studies investigated sex differences in bioactive molecules released from the placenta into the maternal circulation. However, many of the studies have only been conducted in relatively small cohorts, and different framework conditions (time of measurement in pregnancy, BMI of the mother, ethnicity) lead to highly variable results. Only for hCG, by a large number of studies, was revealed that maternal serum levels are increased in pregnancies with females. In addition, further studies are needed that examine the connection between the development of GDM under the influence of placental hormones and the fetal sex in parallel, with adequate size of study groups.