MicroRNA-mediated regulation of hepatic metabolism in pregnancy: current understanding and future perspectives

Pregnancy represents a unique physiological state that involves closely coordinated hormonal, immunological, and metabolic adaptations that ensure an optimal distribution of nutrients between the mother and the fetus. The maternal liver undergoes adaptive changes throughout the anabolic and catabolic phases of this reproductive process, where carbohydrate, lipid, and protein metabolism participate to sustain embryonic development, fetal growth, and maternal energy balance. This mini-review integrates recent in vitro, animal, and clinical evidence on the regulatory functions of microRNAs (miRNAs) small non-coding RNAs that fine-tune gene expression post-transcriptionally in maternal hepatic metabolism during pregnancy. Highlighted miRNAs include miR-29a, miR-351, miR-16-5p, miR-155-5p, miR-146b, and miR-1323, which collectively influence insulin signaling, gluconeogenesis, lipid mobilization, and inflammatory responses in hepatic tissue. Dysregulation of these miRNAs has been linked to metabolic disorders such as obesity, insulin resistance, and gestational diabetes mellitus (GDM). This review focuses on liver-specific expression patterns and pregnancy-associated miRNA pathways, underscoring their potential as early, non-invasive biomarkers as well as therapeutic targets. By deepening the understanding of epigenetic regulation in maternal-fetal metabolic adaptation, this review provides insights into molecular findings with clinical perspectives as key components of translational research.