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Using a Murine Model of Psychosocial Stress in Pregnancy as a Translationally Relevant Paradigm for Psychiatric Disorders in Mothers and Infants
Published on: June 13, 2021
Adrenal disorders in pregnancy.
Silvia Monticone1, Richard J Auchus, William E Rainey
1Department of Physiology, Georgia Health Sciences University, 1120 15th Street, Augusta, GA 30912, USA.
Nature Reviews. Endocrinology
|September 12, 2012
Summary
Pregnancy involves significant endocrine changes, affecting fetal and maternal adrenal glands. This review details common adrenal disorders, their diagnosis, and treatment during gestation.
Area of Science:
- Endocrinology
- Reproductive Medicine
- Perinatal Medicine
Background:
- Pregnancy significantly alters maternal and fetal endocrine systems, including the renin-angiotensin-aldosterone system and hypothalamic-pituitary-adrenal axis.
- The fetoplacental unit, comprising the placenta, fetal adrenal glands, and liver, plays a crucial role in hormone production, particularly oestrogens derived from fetal dehydroepiandrosterone sulphate.
- Adrenal disorders in both fetus and mother can complicate pregnancy, posing risks if not managed promptly.
Purpose of the Study:
- To provide an overview of adrenal steroid metabolism during pregnancy.
- To focus on the diagnosis and management of common fetal and maternal adrenal disorders.
- To address diagnostic challenges due to physiological endocrine changes and lack of reference values.
Main Methods:
- Review of existing literature on adrenal steroid metabolism in pregnancy.
- Analysis of diagnostic criteria for fetal and maternal adrenal disorders.
- Summary of current treatment strategies for these conditions.
Main Results:
- The most frequent fetal adrenal disorder, steroid 21-hydroxylase deficiency, can cause severe developmental abnormalities and neonatal mortality.
- Maternal adrenal disorders, though rare, carry significant risks of mortality and morbidity.
- Accurate diagnosis is frequently hindered by pregnancy-induced hormonal shifts and insufficient reference data.
Conclusions:
- Understanding adrenal steroid metabolism is vital for managing pregnancy-related endocrine complications.
- Prompt diagnosis and treatment of fetal and maternal adrenal disorders are essential for favorable outcomes.
- Further research is needed to establish normative data for adrenal steroids during pregnancy to improve diagnostic accuracy.
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