Hormone signalling between mother and fetus
The developing fetus adapts to an adverse in utero environment, and is programmed to an increased risk of developing disease in later life. Fetal growth is regulated via a complex interplay between mother, placenta and fetus. Maternal nutrients, transported via the placenta, are essential for fetal growth. Conversely, the placenta may also respond to fetal endocrine signals to regulate maternal metabolism. The placenta also regulates fetal growth via production and metabolism of key hormones involved in growth and glucocorticoid metabolism. For example, the enzyme 11 beta hydroxysteroid dehydrogenase type 2 interconverts active cortisol into cortisone, thus protecting the developing fetus from the adverse effects of excess glucocorticoids. Over-exposure to glucocorticoids leads to low birthweight and programmes long term risk of development of diabetes, cardiovascular risk and behavioural problems. While most studies have focused on maternal undernutrition and long-term adverse effects for fetal growth, there is now evidence that overnutrition of the fetus may have similar adverse effects. This is pertinent given the rising prevalence of obesity as currently 1:5 women are obese at the time of pregnancy. We are exploring the factors that influence fetal growth in a cohort of severely obese (BMI>40) pregnant women. Ultimately it is hoped that understanding of the mechanisms regulating fetal growth will have long-term benefits for later health.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This work was supported, however funding details are unavailable.