Prolactin in relation to gestational diabetes and metabolic risk in pregnancy and postpartum: A systematic review and meta-analysis

Rassie, Kate; Giri, Rinky; Joham, Anju E.; Mousa, Aya; Teede, Helena

doi:10.3389/fendo.2022.1069625

Cited by 16 publications

(9 citation statements)

References 61 publications

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“…A recent meta-analysis confirmed that elevated prolactin was associated with lower beta-cell function and higher insulin sensitivity in the postpartum period. However, the direction of causality remains unclear ( 29 ). Lipolysis is also known to contribute to decreasing β-cell function ( 30 ).…”

Section: Discussionmentioning

confidence: 99%

Impact of breastfeeding on risk of glucose intolerance in early postpartum after gestational diabetes

Vanlaer,

Minschart,

Vrolijk

et al. 2024

Front. Endocrinol.

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AimsTo determine the impact of breastfeeding on the risk of postpartum glucose intolerance in women with gestational diabetes.MethodsSub-analysis of two multi-centric prospective cohort studies (BEDIP-N and MELINDA) in 1008 women with gestational diabetes. Data were collected during pregnancy and at a mean of 12 weeks postpartum. Multivariate logistic regression was used to estimate the effect of breastfeeding on glucose intolerance, with adjustment for ethnicity, education, income, professional activity and BMI.ResultsOf all participants, 56.3% (567) breastfed exclusively, 10.1% (102) gave mixed milk feeding and 33.6% (339) did not breastfeed. Mean breastfeeding duration was 3.8 ± 2.4 and 3.7 ± 2.1 months in the breastfeeding and mixed milk feeding groups (p=0.496). The rate of glucose intolerance was lower in both the breastfeeding [22.3% (126)] and mixed milk feeding [25.5% (26)] groups compared to the no breastfeeding group [29.5% (100)], with an adjusted OR of 0.7 (95% CI 0.5–1.0) for glucose intolerance in the breastfeeding group compared to no breastfeeding group and an adjusted OR of 0.7 (95% CI 0.4–1.2) for the mixed milk feeding group compared to the no breastfeeding group. Postpartum, breastfeeding women had a lower BMI, less often postpartum weight retention, lower fasting triglycerides, less insulin resistance and a higher insulin secretion-sensitivity index-2 than the mixed milk feeding and no breastfeeding group. The mixed milk feeding group was more often from an non-White background, had a lower blood pressure and lower fasting triglycerides compared to the no breastfeeding group.ConclusionsBreastfeeding (exclusive and mixed milk feeding) is associated with less glucose intolerance and a better metabolic profile in early postpartum in women with gestational diabetes.

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Section: Discussionmentioning

confidence: 99%

Impact of breastfeeding on risk of glucose intolerance in early postpartum after gestational diabetes

Vanlaer,

Minschart,

Vrolijk

et al. 2024

Front. Endocrinol.

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“…This unstable metabolic state increases blood glucose and free fatty acid levels, further contributing to GDM development. However, no consensus exists on whether these hormones contribute to GDM, as some systematic reviews have discovered no association between placental prolactin and prolactin and an increased GDM risk ( 43 , 61 ). Therefore, further large-scale studies are needed.…”

Section: Placental Adipokines and Cytokinesmentioning

confidence: 99%

Recent progress in metabolic reprogramming in gestational diabetes mellitus: a review

Xie,

Lin,

Xie

et al. 2024

Front. Endocrinol.

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Gestational diabetes mellitus is a prevalent metabolic disease that can impact the normal course of pregnancy and delivery, leading to adverse outcomes for both mother and child. Its pathogenesis is complex and involves various factors, such as insulin resistance and β-cell dysfunction. Metabolic reprogramming, which involves mitochondrial oxidative phosphorylation and glycolysis, is crucial for maintaining human metabolic balance and is involved in the pathogenesis and progression of gestational diabetes mellitus. However, research on the link and metabolic pathways between metabolic reprogramming and gestational diabetes mellitus is limited. Therefore, we reviewed the relationship between metabolic reprogramming and gestational diabetes mellitus to provide new therapeutic strategies for maternal health during pregnancy and reduce the risk of developing gestational diabetes mellitus.

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“…Results for hPL have been synthesised and reported elsewhere [14]. Eleven of the PRL studies explicitly examined PRL in relation to pre-existing maternal metabolic conditions and were included in the present review; the remaining 24 examined PRL in relation to broader aspects of maternal metabolism (including gestational diabetes mellitus) and have been reported elsewhere [15].…”

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

Prolactin in Pregnancies Affected by Pre-Existing Maternal Metabolic Conditions: A Systematic Review

Rassie

Giri

Joham

et al. 2023

IJMS

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Women affected by maternal pregestational diabetes mellitus (type 1 or type 2) or by polycystic ovary syndrome experience an increased risk of pregnancy complications, as well as suboptimal lactation outcomes. The hormone prolactin plays important roles in pregnancy and postpartum, both as a metabolic and lactogenic hormone. We aimed to explore, through a systematic review, the relationship between pregestational maternal metabolic conditions and prolactin levels in pregnancy and postpartum. MEDLINE via OVID, CINAHL Plus, and Embase were searched from inception to 9 May 2022. Eligible studies included women who were pregnant or up to 12 months postpartum and had a pre-existing diagnosis of type 1 or type 2 diabetes mellitus or polycystic ovary syndrome; with reporting of at least one endogenous maternal serum prolactin level during this time. Two independent reviewers extracted the data. Eleven studies met the eligibility criteria. The studies were too diverse and heterogeneous to enable meta-analysis. Overall, prolactin levels appeared to be lower in pregnancies affected by type 1 diabetes mellitus. There was little data in polycystic ovary syndrome or type 2 diabetes pregnancy, but prolactin increment across pregnancy in polycystic ovary syndrome emerged as an area for future study. During postpartum, lactation difficulties in women with metabolic disease present before pregnancy are well-described, but the relationship to prolactin remains unclear. Overall, preliminary evidence suggests that pre-existing maternal metabolic disease may alter prolactin dynamics in pregnancy and postpartum. Further well-designed studies in modern cohorts, with standardised collection and serial sampling across pregnancy and postpartum, are required to clarify these associations.

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Prolactin in relation to gestational diabetes and metabolic risk in pregnancy and postpartum: A systematic review and meta-analysis

Cited by 16 publications

References 61 publications

Impact of breastfeeding on risk of glucose intolerance in early postpartum after gestational diabetes

Impact of breastfeeding on risk of glucose intolerance in early postpartum after gestational diabetes

Recent progress in metabolic reprogramming in gestational diabetes mellitus: a review

Prolactin in Pregnancies Affected by Pre-Existing Maternal Metabolic Conditions: A Systematic Review

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