Dari Otot ke Plasenta: Potensi Aktivitas Fisik Prenatal sebagai Terapi Pensinyalan Metabolik dalam Pemrograman Fetomaternal
DOI:
https://doi.org/10.58344/locus.v5i7.6181Keywords:
aktivitas fisik prenatal, miokin, plasenta, mtor, ampkAbstract
Lingkungan metabolik maternal memengaruhi fungsi plasenta dan kesehatan keturunan di masa depan. Aktivitas fisik selama kehamilan memberikan manfaat klinis yang konsisten, tetapi jalur biologis yang menghubungkan kontraksi otot dengan respons plasenta belum banyak dibahas secara terpadu dalam praktik fetomaternal. Menelaah fungsi endokrin otot rangka, adaptasi metabolik maternal, pensinyalan nutrien plasenta, dan pemrograman perkembangan janin sebagai dasar untuk memahami aktivitas fisik prenatal sebagai terapi pensinyalan metabolik. Artikel ini merupakan focused narrative review dengan perspektif translasi. Literatur tahun 2020–2025 ditelusuri melalui PubMed, Scopus, dan Web of Science menggunakan kombinasi istilah exercise in pregnancy, physical activity, myokines, maternal metabolism, placental signaling, mTOR, AMPK, dan fetal programming. Referensi seminal sebelum 2020 digunakan untuk menjelaskan konsep dasar. Studi manusia diprioritaskan untuk implikasi klinis, sedangkan studi eksperimental digunakan untuk membahas mekanisme yang belum dapat dinilai langsung pada manusia. Kontraksi otot meningkatkan pelepasan miokin dan mengaktifkan jalur AMPK–GLUT-4, yang mendukung ambilan glukosa, oksidasi lipid, dan pengendalian inflamasi. Perbaikan sensitivitas insulin, profil adipokin, dan fungsi endotel diduga menjadi jalur utama yang menghubungkan aktivitas fisik dengan perfusi serta pensinyalan nutrien plasenta. Keseimbangan mTOR–AMPK merupakan salah satu mekanisme kandidat yang menghubungkan status energi maternal dengan transport nutrien. Bukti klinis paling kuat mendukung keamanan dan manfaat aktivitas fisik terhadap luaran maternal. Sebaliknya, bukti mengenai miokin, perubahan epigenetik, dan luaran metabolik jangka panjang pada anak masih didominasi studi eksperimental. Aktivitas fisik selama kehamilan sebaiknya diberikan sebagai intervensi klinis yang terstruktur, bukan sekadar anjuran umum.
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