TY - JOUR
T1 - Prolactin in relation to gestational diabetes and metabolic risk in pregnancy and postpartum
T2 - A systematic review and meta-analysis
AU - Rassie, Kate
AU - Giri, Rinky
AU - Joham, Anju E.
AU - Mousa, Aya
AU - Teede, Helena
N1 - Funding Information:
This project received no specific funding. KR is supported by a postgraduate research scholarship from the National Health and Medical Research Council (NHMRC) of Australia. AJ is supported by an NHMRC Centre for Research Excellence (CRE) fellowship. AM is supported by an NHMRC biomedical research fellowship. HT is a NHMRC Leadership Research fellow.
Publisher Copyright:
Copyright © 2022 Rassie, Giri, Joham, Mousa and Teede.
PY - 2022/12/22
Y1 - 2022/12/22
N2 - Context: Pre-clinical evidence suggests that prolactin has important metabolic functions in pregnancy and postpartum, in addition to lactogenic actions. Objective: To explore the relationship between prolactin and maternal metabolic outcomes in human pregnancy and postpartum, particularly in relation to gestational diabetes mellitus (GDM). Data sources: MEDLINE via OVID, CINAHL plus, Embase. Study selection: Eligible 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 extraction: Two independent reviewers extracted data. Data synthesis: Twenty-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. Conclusions: Current 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 registration: https://www.crd.york.ac.uk/prospero/, identifier [CRD42021262771].
AB - Context: Pre-clinical evidence suggests that prolactin has important metabolic functions in pregnancy and postpartum, in addition to lactogenic actions. Objective: To explore the relationship between prolactin and maternal metabolic outcomes in human pregnancy and postpartum, particularly in relation to gestational diabetes mellitus (GDM). Data sources: MEDLINE via OVID, CINAHL plus, Embase. Study selection: Eligible 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 extraction: Two independent reviewers extracted data. Data synthesis: Twenty-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. Conclusions: Current 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 registration: https://www.crd.york.ac.uk/prospero/, identifier [CRD42021262771].
KW - gestational diabetes mellitus
KW - lactation
KW - obesity
KW - postpartum
KW - pregnancy
KW - prolactin
UR - http://www.scopus.com/inward/record.url?scp=85145504372&partnerID=8YFLogxK
U2 - 10.3389/fendo.2022.1069625
DO - 10.3389/fendo.2022.1069625
M3 - Review Article
C2 - 36619539
AN - SCOPUS:85145504372
SN - 1664-2392
VL - 13
JO - Frontiers in Endocrinology
JF - Frontiers in Endocrinology
M1 - 1069625
ER -
