Adrenal disorders in pregnancy

Abstract

Pregnancy dramatically affects the function of the adrenal glands and is associated with altered levels of adrenal hormones. Endocrine adaptation to pregnancy involves changes in the activities of the hypothalamic-pituitary-adrenal and renin-angiotensin-aldosterone axes. As a result, pregnancy may influence the course of pre-existing adrenal diseases or lead to their unmasking. Although disorders of the adrenal glands are rare during pregnancy, they may pose a serious health problem. The fact that some symptoms of adrenal disorders may be erroneously interpreted as symptoms of normal pregnancy together with overlapping their biochemical features make diagnosis of adrenal disorders in pregnancy difficult. Antenatal diagnosis and correct treatment of these disorders is necessary to prevent maternal and fetal morbidity and mortality. The aim of this paper is provide a scientific understanding of the normal function of adrenal glands in pregnancy and to discuss the pathophysiology, clinical manifestation, diagnosis and management of various adrenal disorders during pregnancy. We provide the reader with some practical recommendations concerning the approach to pregnant women with adrenal disturbances.