Nuclear Receptors in Pregnancy and Outcomes: Clinical Perspective

Pregnancy is characterised by profound hormonal and metabolic changes in the mother. Both oestrogen and progesterone, along with their respective nuclear receptors, have an important role in maintaining a healthy pregnancy. Equally, other nuclear receptors such as LXR, FXR and the PPARs play important roles in the gradual alterations in metabolism that ensure survival of mother and fetus. Disruptions in nuclear receptor signalling can result in pregnancy disorders such as gestational diabetes mellitus, intrahepatic cholestasis of pregnancy, hypertensive disorders of pregnancy and preterm labour, all of which have both immediate and long-term implications for maternal and fetal health. By reviewing data from human studies and animal models, this chapter will describe the contribution of nuclear receptors to normal pregnancy, their role in gestational disorders and their potential as therapeutic targets.