Progress and Practice of Insulin Resistance in Pregnancy: From Pathogenesis to Management

Evidence suggests that the degree of insulin resistance in pregnancy (IRiP) seems to affect pregnancy outcomes regardless of the presence of gestational diabetes. A physiological moderate increase in IRiP is a protective factor for fetal development, but excessive enhancement can lead to maternal metabolic disorders and placental dysfunction, increasing the risk of gestational diabetes and adverse pregnancy outcomes, as well as having adverse effects on the long-term health of the offspring. This review briefly explores the key factors influencing IRiP, including pregnancy-specific and non-pregnancy-specific factors. It also discusses the assessment methods for insulin resistance that can be implemented during pregnancy and the increased probabilities of adverse effects on both the mother and the offspring, such as preeclampsia or eclampsia, neonatal hypoglycemia, and the risk of obesity and metabolic diseases in the offspring in the future. Finally, the intervention strategies were briefly described, such as in terms of diet, exercise, and medication, etc. This provides a basis and insights for the management and research of IRiP.