Melatonin and pregnancy: neurophysiology, influence on the pathological conditions of the mother and fetus, participation in fetal programming (Analysis of literature)

The interest of researchers in melatonin is due to its influence both on the reproductive health of women - successful ovulation, conception, pregnancy and delivery - and fetal health and programming of its diseases after birth. Melatonin, synthesized in the ovary, is involved in the maturation of the egg, protects against damaging effects of free radicals, promotes the development of the yellow body and the formation of progesterone. Normal circadian release of melatonin is involved in the correction of various pathological conditions that arise during pregnancy - sleep disorders, pre-eclampsia, paroxysmal disorders, HELLP syndrome. Throughout the pregnancy, melatonin circadian passes through the placental barrier, affecting the development and synchronization of the suprachiasmal nucleus of the hypothalamus in the fetus. The antioxidant properties of melatonin make it possible to optimize the reproductive physiology of pregnant women, eliminating undesirable oxidation-nitrosation reactions in the cells of the ovaries, uterus and placenta. Deficiency of the pineal and extrapineal circadian secretion of melatonin into reproductive cells, the violation of axonal transmission and the susceptibility of melatonin receptors in the maternal and fetal organs, leads to the development of a wide range of endocrine, immune and vegetative disorders in them. The pro-inflammatory activity of melatonin is caused by the removal of toxic oxygen and nitrogen from cells both by direct absorption and by metabolizing them into non-reactive products, by limiting the production of various pro-inflammatory molecules (prostanoids, leukotrienes, cytokines). The anxiolytic and analgesic effects of melatonin are realized through the action on opioid μ- and β-endorphin receptors. The use of exogenous melatonin in obstetrical practice makes it possible to control labor activity in women, contributing to a favorable delivery. Melatonin is effective in correcting asphyxia in newborns due to suppression of oxidative stress and influence on survival growth. At the same time, the neurophysiological, clinical, ethical, diagnostic and therapeutic aspects of the action of melatonin on a pregnant woman and her fetus are still insufficiently studied. The role of melatonin in obstetrics and gynecology is not clear and far from being resolved. All this makes this problem relevant and promising for study.

melatonin, sleep disorder, pregnancy, fetus, circadian rhythm, review

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