As demonstrated by the Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) Study and other population-based studies, maternal glucose levels during pregnancy vary markedly among women, with some women having levels associated with adverse newborn outcomes. Maternal glucose metabolism during pregnancy differs from the non-gravid state as the mother must meet both her own and the growing fetus’s energy needs. Future studies that integrate data from multiple technologies will allow an integrated systems biology approach to maternal metabolism during pregnancy. Metabolomics and genomics are but a few of the now available high-throughput ‘omics’ technologies. Measurement of amino acids and conventional metabolites have demonstrated changes in mothers with higher insulin resistance and glucose similar to changes in non-gravid, insulin-resistant populations, suggesting similarities in the metabolic profile characteristic of insulin resistance and hyperglycaemia in pregnant and non-pregnant populations. Metabolomics has also been used to profile the metabolic state of women during pregnancy through the multiplexed measurement of many low molecular weight metabolites. More recent genome-wide association studies examining maternal metabolism during pregnancy have demonstrated overlap of genes associated with metabolic traits in the gravid and non-gravid population, as well as genes that appear to be relatively unique to pregnancy.

Following the identification of susceptibility genes for Type 2 diabetes through genome-wide association studies, association has been demonstrated of some Type 2 diabetes susceptibility genes with gestational diabetes mellitus, suggesting that the genetic architecture of Type 2 diabetes and gestational diabetes are, in part, similar. This review focuses on the application of genetics/genomics and metabolomics to the study of maternal metabolism during pregnancy.

New insights into the mechanisms underlying maternal metabolism during pregnancy are being gained through the use of new ‘omics’ technologies. Maternal glucose metabolism during pregnancy differs from the non-gravid state to allow the mother to meet her own and the growing fetus’s energy needs.

Ronzoni manico