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

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#infant-newborn #pregnancy #female #humans #placental-insufficiency

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

Fantasia et al., 2022 | Eur J Obstet Gynecol Reprod Biol | Systematic Review

Citation

Fantasia Ilaria, Bussolaro Sofia, ... Rolnik Daniel L. The role of melatonin in pregnancies complicated by placental insufficiency: A systematic review. Eur J Obstet Gynecol Reprod Biol. 2022-Nov;278:22-28. doi:10.1016/j.ejogrb.2022.08.029

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.

Key Findings

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.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size See abstract
Age Range See abstract
Condition stress

MeSH Terms

  • Infant, Newborn
  • Pregnancy
  • Female
  • Humans
  • Placental Insufficiency
  • Pre-Eclampsia
  • Melatonin
  • Fetal Growth Retardation
  • Placenta
  • Antioxidants
  • Receptors, Melatonin
  • Premature Birth
  • Aspirin
  • Randomized Controlled Trials as Topic

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Systematic Review, Journal Article
  • Vertical: melatonin

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09