During the second 20 weeks of pregnancy, the maternal metabolism is characterized by which of the following?

During the second 20 weeks of pregnancy, the maternal metabolism is characterized by which of the following?

• A. Anabolic with fat storage
• B. Catabolic with increased diabetogenic hormones blocking insulin leading to higher blood glucose
• C. Increased insulin sensitivity and glucose uptake by tissues
• D. No significant metabolic changes

Answer: (B)

In the second half of pregnancy, maternal metabolism shifts to a catabolic state driven by diabetogenic placental hormones. Hormones such as human placental lactogen, cortisol, progesterone, and growth hormone reduce insulin sensitivity, so glucose stays in the bloodstream rather than being taken up efficiently by maternal tissues. This ensures more glucose is available for the fetus while maternal energy comes from mobilizing fat stores. The result is higher blood glucose and a move toward catabolism rather than storage. This differs from early pregnancy, when metabolism is more anabolic with fat storage, and from states of increased insulin sensitivity or no change, which don’t describe the insulin-resistant, glucose-sparing milieu that develops as pregnancy progresses.

In the second half of pregnancy, maternal metabolism shifts to a catabolic state driven by diabetogenic placental hormones. Hormones such as human placental lactogen, cortisol, progesterone, and growth hormone reduce insulin sensitivity, so glucose stays in the bloodstream rather than being taken up efficiently by maternal tissues. This ensures more glucose is available for the fetus while maternal energy comes from mobilizing fat stores. The result is higher blood glucose and a move toward catabolism rather than storage.

This differs from early pregnancy, when metabolism is more anabolic with fat storage, and from states of increased insulin sensitivity or no change, which don’t describe the insulin-resistant, glucose-sparing milieu that develops as pregnancy progresses.