Placental insufficiency affects about 10% of pregnancies and can lead to pre-eclampsia, fetal growth restriction, and preterm birth. Despite significant advances in early prediction and prevention of preterm pre-eclampsia with aspirin, the effects of prophylaxis on fetal growth restriction are less certain, and the rates of late-onset pre-eclampsia are not influenced by aspirin treatment. Pregnancies complicated by placental insufficiency are characterized by increased oxidative stress, and recent studies suggest that melatonin has antioxidant properties and contributes to maintaining placental homeostasis. We aimed to systematically review the available literature about melatonin in pregnancies complicated by placental insufficiency, specifically preeclampsia and fetal growth restriction, exploring three different aspects: 1) maternal melatonin levels; 2) expression and activity of melatonin placental receptors; 3) effects of maternal melatonin administration. PubMed (Medline) and Scopus were searched until December 2020. Identified studies were screened and assessed independently by two authors. Data were extracted and compiled in qualitative evidence synthesis. The circadian pattern of melatonin secretion seems to be altered in pregnancies complicated by placental insufficiency reflected by lower production of melatonin, with consequent lower systemic and placental concentrations and lower expression of melatonin receptors, thus reducing the local release of the indole and its autocrine function. Small intervention studies also suggest that treatment is safe and may lead to prolongation of pregnancy and better outcomes, but double-blind, randomized placebo-controlled trials are lacking.

The role of melatonin in pregnancies complicated by placental insufficiency: A systematic review

Fantasia, Ilaria
;
Bussolaro, Sofia;Stampalija, Tamara;
2022

Abstract

Placental insufficiency affects about 10% of pregnancies and can lead to pre-eclampsia, fetal growth restriction, and preterm birth. Despite significant advances in early prediction and prevention of preterm pre-eclampsia with aspirin, the effects of prophylaxis on fetal growth restriction are less certain, and the rates of late-onset pre-eclampsia are not influenced by aspirin treatment. Pregnancies complicated by placental insufficiency are characterized by increased oxidative stress, and recent studies suggest that melatonin has antioxidant properties and contributes to maintaining placental homeostasis. We aimed to systematically review the available literature about melatonin in pregnancies complicated by placental insufficiency, specifically preeclampsia and fetal growth restriction, exploring three different aspects: 1) maternal melatonin levels; 2) expression and activity of melatonin placental receptors; 3) effects of maternal melatonin administration. PubMed (Medline) and Scopus were searched until December 2020. Identified studies were screened and assessed independently by two authors. Data were extracted and compiled in qualitative evidence synthesis. The circadian pattern of melatonin secretion seems to be altered in pregnancies complicated by placental insufficiency reflected by lower production of melatonin, with consequent lower systemic and placental concentrations and lower expression of melatonin receptors, thus reducing the local release of the indole and its autocrine function. Small intervention studies also suggest that treatment is safe and may lead to prolongation of pregnancy and better outcomes, but double-blind, randomized placebo-controlled trials are lacking.
5-set-2022
Pubblicato
https://pubmed.ncbi.nlm.nih.gov/36108451/
File in questo prodotto:
File Dimensione Formato  
1-s2.0-S0301211522004948-main.pdf

non disponibili

Tipologia: Documento in Versione Editoriale
Licenza: Copyright Editore
Dimensione 967.81 kB
Formato Adobe PDF
967.81 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
1-s2.0-S0301211522004948-mmc1.pdf

non disponibili

Tipologia: Altro materiale allegato
Licenza: Digital Rights Management non definito
Dimensione 605.28 kB
Formato Adobe PDF
605.28 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
FigureS1_risk-of-bias-QUADAS.pdf

non disponibili

Tipologia: Altro materiale allegato
Licenza: Digital Rights Management non definito
Dimensione 25.02 kB
Formato Adobe PDF
25.02 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
FigureS2_risk-of-bias-ROBINS-I.pdf

non disponibili

Tipologia: Altro materiale allegato
Licenza: Digital Rights Management non definito
Dimensione 24.8 kB
Formato Adobe PDF
24.8 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11368/3031099
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus 0
  • ???jsp.display-item.citation.isi??? ND
social impact