Lactogenic hormones in relation to maternal metabolic health in pregnancy and postpartum: protocol for a systematic review

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

doi:10.1136/bmjopen-2021-055257

Cited by 11 publications

(9 citation statements)

References 46 publications

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“…However, higher firsttrimester serum prolactin levels indicate increased insulin resistance in pregnant women and a higher chance of developing gestational diabetes mellitus. 14 Kampmann et al in a review study, elaborated on serum prolactin's role as a possible mediator of the change in insulin sensitivity in pregnancy. This change is essential to maintain adequate serum glucose levels in the maternal-fetal compartment.…”

Section: Discussionmentioning

confidence: 99%

Serum Prolactin as an Early Biomarker for Detection of Gestational Diabetes Mellitus-An Experience at CMH Quetta

Ahmed

Bashir²,

Lqbal³

et al. 2023

PAFMJ

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Objective: To determine the association between elevated serum prolactin and the development of gestational diabetes mellitus in the first trimester. Study Design: Prospective longitudinal study. Place and Duration of Study: Pathology Department, Combined Military Hospital, Quetta Pakistan, from Apr 2021 to Mar 2022. Methodology: One hundred and twenty-one patients had a measurement of serum prolactin in the first trimester, along with an oral glucose tolerance test in the second and third trimester, at the Pathology Department Combined Military Hospital Quetta Pakistan. Results: In the study group, serum prolactin levels were raised in 51(42.1%) patients in the first trimester. A total of 44(36.3%) patients with raised serum prolactin had impaired oral glucose tolerance tests. A significant association was found between raised serum prolactin and subsequent development of gestational diabetes mellitus in pregnant females. Conclusion: Serum prolactin can be an important biomarker for early diagnosis and monitoring of gestational diabetes mellitus.

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Section: Discussionmentioning

confidence: 99%

Serum Prolactin as an Early Biomarker for Detection of Gestational Diabetes Mellitus-An Experience at CMH Quetta

Ahmed

Bashir²,

Lqbal³

et al. 2023

PAFMJ

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“…This review is part of a larger evidence synthesis examining lactogenic hormones in pregnancy and postpartum, and was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 guidelines. A protocol for this review is published [ 10 ] and was registered with the International Prospective Register of Systematic Reviews (PROSPERO), CRD42021262771.…”

Section: Methodsmentioning

confidence: 99%

Human Placental Lactogen in Relation to Maternal Metabolic Health and Fetal Outcomes: A Systematic Review and Meta-Analysis

Rassie

Giri

Joham

et al. 2022

IJMS

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Human placental lactogen (hPL) is a placental hormone which appears to have key metabolic functions in pregnancy. Preclinical studies have putatively linked hPL to maternal and fetal outcomes, yet—despite human observational data spanning several decades—evidence on the role and importance of this hormone remains disparate and conflicting. We aimed to explore (via systematic review and meta-analysis) the relationship between hPL levels, maternal pre-existing and gestational metabolic conditions, and fetal growth. MEDLINE via OVID, CINAHL plus, and Embase were searched from inception through 9 May 2022. Eligible studies included women who were pregnant or up to 12 months post-partum, and reported at least one endogenous maternal serum hPL level during pregnancy in relation to pre-specified metabolic outcomes. Two independent reviewers extracted data. Meta-analysis was conducted where possible; for other outcomes narrative synthesis was performed. 35 studies met eligibility criteria. No relationship was noted between hPL and gestational diabetes status. In type 1 diabetes mellitus, hPL levels appeared lower in early pregnancy (possibly reflecting delayed placental development) and higher in late pregnancy (possibly reflecting increased placental mass). Limited data were found in other pre-existing metabolic conditions. Levels of hPL appear to be positively related to placental mass and infant birthweight in pregnancies affected by maternal diabetes. The relationship between hPL, a purported pregnancy metabolic hormone, and maternal metabolism in human pregnancy is complex and remains unclear. This antenatal biomarker may offer value, but future studies in well-defined contemporary populations are required.

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“…A protocol for this review has been previously published ( 11 ). The review is part of a larger evidence synthesis examining lactogenic hormones in pregnancy and postpartum, was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, and is registered with the International Prospective Register of Systematic Reviews (PROSPERO), CRD42021262771.…”

Section: Methodsmentioning

confidence: 99%

“…Selection criteria using a modified version of the Participant, Exposure, Comparison, Outcome and Study Type (PECOT) framework ( 11 , 12 ), established a priori , were used to determine the eligibility of articles for inclusion in this review. Using this framework, studies were included when the following criteria were fulfilled: participants were pregnant women and women up to 12 months postpartum, regardless of lactation status and with any comparison group (or no comparison); endogenous maternal serum PRL must have been measured and reported at least once during pregnancy and/or up to 12 months postpartum; and at least one of the key maternal outcomes below were reported:…”

Section: Methodsmentioning

confidence: 99%

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

et al. 2022

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ContextPre-clinical evidence suggests that prolactin has important metabolic functions in pregnancy and postpartum, in addition to lactogenic actions.ObjectiveTo explore the relationship between prolactin and maternal metabolic outcomes in human pregnancy and postpartum, particularly in relation to gestational diabetes mellitus (GDM).Data sourcesMEDLINE via OVID, CINAHL plus, Embase.Study selectionEligible studies included women who were pregnant or up to 12 months postpartum, reporting at least one maternal serum prolactin level in relation to key metabolic outcomes including GDM, glycaemic parameters, obesity, and gestational weight gain.Data extractionTwo independent reviewers extracted data.Data synthesisTwenty-six articles were included. Meta-analysis showed no relationship between maternal prolactin levels and GDM status, with a weighted mean difference of -2.14 ng/mL (95% CI -12.54 to 8.27 ng/mL, p=0.7) between GDM and controls in early pregnancy (n=3 studies) and -3.89 ng/mL (95% CI, -15.20 to 7.41 ng/mL, p=0.5) in late pregnancy (n=11 studies). In narrative synthesis of other outcomes (due to study heterogeneity and/or lack of data), prolactin levels were not associated with maternal glycaemic or weight-related parameters during pregnancy, but in the postpartum period (particularly with lactation) a high-prolactin environment was associated with low circulating insulin and beta-cell function, and increased insulin sensitivity.ConclusionsCurrent evidence from human studies does not clearly support a relationship between prolactin and metabolic parameters during pregnancy, including with GDM status. Elevated prolactin was associated with lower insulin and beta-cell function and higher insulin sensitivity in the post-partum period, but the direction of causality remains unclear.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier [CRD42021262771].

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Lactogenic hormones in relation to maternal metabolic health in pregnancy and postpartum: protocol for a systematic review

Cited by 11 publications

References 46 publications

Serum Prolactin as an Early Biomarker for Detection of Gestational Diabetes Mellitus-An Experience at CMH Quetta

Serum Prolactin as an Early Biomarker for Detection of Gestational Diabetes Mellitus-An Experience at CMH Quetta

Human Placental Lactogen in Relation to Maternal Metabolic Health and Fetal Outcomes: A Systematic Review and Meta-Analysis

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

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