In pregnancy, cortisol primarily regulates which metabolic processes?

• A. Carbohydrate and protein metabolism
• B. Calcium homeostasis
• C. Water balance
• D. Growth and development of placenta

Answer: (A)

Cortisol acts as a glucocorticoid that primarily influences carbohydrate and protein metabolism. It stimulates hepatic gluconeogenesis and promotes protein catabolism to provide amino acids for glucose production, helping to ensure a steady energy supply for both the mother and the developing fetus. In pregnancy, rising cortisol levels support longer periods without meals by increasing glucose availability, while also contributing to maternal insulin resistance to prioritize fetal glucose delivery. However, fetal exposure to cortisol is regulated by placental enzymes (11β-HSD2) to limit excessive effects on the fetus.

Calcium homeostasis is governed mainly by parathyroid hormone and vitamin D, not cortisol. Water balance is controlled largely by antidiuretic hormone and aldosterone. Growth and development of the placenta are driven by hormones like estrogen, progesterone, hCG, and placental growth factors, rather than cortisol.