Successful pregnancies rely on sufficient energy and nutrient supply, which require the mother to metabolically adapt to support fetal needs. The placenta has a critical role in this process, as this specialized organ produces hormones and peptides that regulate fetal and maternal metabolism. The ability for the mother to metabolically adapt to support the fetus depends on maternal prepregnancy health. Two-thirds of pregnancies in the United States involve obese or overweight women at the time of conception. This poses significant risks for the infant and mother by disrupting metabolic changes that would normally occur during pregnancy. Despite well characterized functions of placental hormones, there is scarce knowledge surrounding placental endocrine regulation of maternal metabolic trends in pathological pregnancies. In this review, we discuss current efforts to close this gap of knowledge and highlight areas where more research is needed. As the intrauterine environment predetermines the health and wellbeing of the offspring in later life, adequate metabolic control is essential for a successful pregnancy outcome. Understanding how placental hormones contribute to aberrant metabolic adaptations in pathological pregnancies may unveil disease mechanisms and provide methods for better identification and treatment. Studies discussed in this review were identified through PubMed searches between the years of 1966 to the present. We investigated studies of normal pregnancy and metabolic disorders in pregnancy that focused on energy requirements during pregnancy, endocrine regulation of glucose metabolism and insulin resistance, cholesterol and lipid metabolism, and placental hormone regulation.

中文翻译：

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人类妊娠期间能量稳态的胎盘调节。

成功的怀孕依赖于充足的能量和营养供应，这需要母亲在新陈代谢上适应支持胎儿的需要。胎盘在这个过程中起着关键作用，因为这个专门的器官会产生调节胎儿和母体新陈代谢的激素和肽。母亲代谢适应支持胎儿的能力取决于母亲孕前的健康状况。在美国，三分之二的怀孕涉及怀孕时肥胖或超重的女性。这会破坏通常在怀孕期间发生的代谢变化，从而给婴儿和母亲带来重大风险。尽管胎盘激素的功能已得到充分表征，但关于病理妊娠中母体代谢趋势的胎盘内分泌调节的知识却很少。在这篇评论中，我们讨论了当前为缩小这一知识差距所做的努力，并强调了需要更多研究的领域。由于宫内环境预先决定了后代在以后生活中的健康和福祉，因此适当的代谢控制对于成功的妊娠结果至关重要。了解胎盘激素如何导致病理性妊娠的异常代谢适应可能揭示疾病机制并提供更好的识别和治疗方法。本综述中讨论的研究是通过 1966 年至今的 PubMed 搜索确定的。我们调查了正常妊娠和妊娠期代谢紊乱的研究，重点关注妊娠期的能量需求、葡萄糖代谢和胰岛素抵抗的内分泌调节、胆固醇和脂质代谢，