Search Results (761)

We investigated the association between gestational diabetes mellitus (GDM) and the rate of peripartum infections (chorioamnionitis and/or endometritis). A retrospective cohort study was conducted using data collected between January 2014 and July 2021. The study group comprised women with GDM, while the control group consisted of women without GDM, matched for age ≥ 35 Y, primiparity, pre-gestational body mass index (BMI), cesarean and vacuum deliveries, and preterm deliveries. The primary outcome was the rate of peripartum infections. Data from 1683 GDM women and 1683 matched controls were analyzed. No significant difference was observed in the rate of peripartum infections between the GDM and control groups (26 (1.5%) versus 14 (0.8%), respectively; p = 0.056), nor in the rates of other infections. After controlling for epidural analgesia rate, BMI, age, and delivery week in multivariable logistic regression, the rate of peripartum infections remained statistically insignificant between the GDM group and controls (OR 1.8, 95% CI 0.9–3.4). The main pathogens isolated in cases of peripartum infections were similar in both groups, primarily consisting of Escherichia coli and Group B Streptococcus. No difference in the rate of study outcomes was observed when vaginal and cesarean deliveries were analyzed separately. Altogether, GDM was not associated with an increased risk for peripartum infections. Full article

Gestational diabetes mellitus (GDM) increases the risk of fetal overgrowth and macrosomia, yet the molecular mechanisms remain unclear. Emerging evidence implicates primate-specific placental microRNAs (miRNAs) from the C19MC cluster in modulating fetal growth via the insulin-like growth factor (IGF) axis. This study aimed to investigate the expression of circulating C19MC miRNAs in GDM pregnancies and their association with IGF axis biomarkers and birthweight outcomes. In this cross-sectional study, 158 pregnant women were stratified into normoglycemic pregnancies (n = 52), GDM with normal birthweight (n = 56), and GDM with large-for-gestational-age (LGA) newborns (n = 50). Plasma levels of 19 C19MC miRNAs and IGF-related proteins were measured. Associations between miRNAs, IGF axis components, and birthweight were analyzed using linear regression and correlation models adjusted for relevant covariates. Several miRNAs, including miR-516a-5p, miR-518d-3p, miR-521, and miR-525-3p, were differentially expressed in GDM, particularly in LGA cases. Strong correlations were observed, such as that of miR-516a-5p with IGFBP-5 (r = 0.705; p < 0.001). Inverse associations with birthweight were found for miR-519b-3p, miR-518d-5p, and miR-520a-5p. Circulating C19MC miRNAs are dysregulated in GDM and correlate with IGF signaling and fetal growth, supporting their potential as early biomarkers for macrosomia risk in GDM. Full article

(1) Background: Gestational diabetes mellitus (GDM) is a glucose metabolism disorder that typically develops in the second half of pregnancy, transforming a normal pregnancy into a high-risk condition, with both short- and long-term complications for the mother and the fetus. Achieving optimal glycaemic control during pregnancy is essential for preventing these outcomes and could be realized using continuous glucose monitoring systems (CGMSs). This systematic review aims to evaluate the role of the CGMS as a potential diagnostic aid and predictor of maternal and fetal outcomes in GDM. (2) Methods: Following the PRISMA guidelines (protocol ID: CRD42024559169), we performed a literature search using the terms “(continuous glucose monitoring system OR CGMS) AND (gestational diabetes mellitus OR GDM)” in the PubMed, Web of Science, and Scopus databases. (3) Results: Twelve studies were included, all reporting data on CGMS use in pregnancies complicated by GDM. The data included in our analysis are heterogeneous, the results suggesting that the CGMS may offer several advantages such as improved glycaemic control (by avoiding hyper- and hypoglycaemia), better gestational weight management, timely initiation of pharmacologic treatment, lower rates of preeclampsia, and improved neonatal outcomes. (4) Conclusions: the CGMS offers a more detailed assessment of both maternal and fetal exposure to high glucose levels, which could lead to earlier detection of those at risk for GDM complications and better guide treatment regimens, especially timely pharmacological intervention. While the current data are heterogeneous, reporting both limited or no benefits and superior benefits compared to the classic monitoring, larger longitudinal studies are mandatory to validate these findings and to better refine the role of CGMS in the monitoring and management of GDM. Full article

Gestational diabetes mellitus (GDM) is a growing global health concern, driving the need for novel diagnostic and prognostic approaches. The aim of this study was to analyze the amino acid profile in the mother–fetus system (maternal venous blood, umbilical cord blood, and amniotic fluid) and to identify specific biological markers of GDM and macrosomia. Using HPLC-MS/MS, we analyzed serum from maternal venous and umbilical cord blood, along with amniotic fluid, across 94 mother–fetus pairs (53 GDM, 41 controls). Machine learning and metabolic pathway analysis revealed significant alterations in 19 amino acids. In GDM, maternal serum showed elevated 5-OH-lysine and homocitrulline, while cord blood had higher isoleucine, serine, and threonine. Amniotic fluid exhibited increased leucine, isoleucine, threonine, serine, arginine, and ornithine. Conversely, histidine, glutamine, alanine, asparagine, β-/γ-aminobutyric acids, phenylalanine, ornithine, and citrulline were reduced. Histidine, glutamine, and asparagine inversely correlated with blood glucose (r = −0.26, r = −0.33, r = −0.30) and were lower in GDM. These findings highlight three key metabolic loci in GDM pathogenesis, with glutamine, histidine, and asparagine emerging as potential maternal blood biomarkers for early macrosomia prediction. However, given confounding factors in metabolomic studies, further large-scale validation is essential. Full article

Oxidative stress, defined as the imbalance between reactive oxygen species (ROS) and antioxidant defenses, plays a pivotal role in the pathogenesis of several pregnancy complications, notably preeclampsia (PE), gestational diabetes mellitus (GDM), fetal growth restriction (FGR), and recurrent pregnancy loss (RPL). During normal pregnancy, low to moderate ROS levels support essential placental functions such as angiogenesis and trophoblast differentiation. However, excessive ROS production overwhelms antioxidant systems, leading to lipid peroxidation, protein and DNA damage, and impaired placental function. This review synthesizes current evidence linking oxidative stress to adverse pregnancy outcomes, highlighting key biomarkers such as malondialdehyde (MDA), 8-hydroxy-2′-deoxyguanosine (8-OHdG), and 8-iso-prostaglandin F2α (8-iso-PGF2α). While antioxidant therapies—particularly vitamins C and E, selenium, and folic acid—have shown promise in reducing oxidative markers, their impact on clinical outcomes remains inconsistent. The variability in results underscores the need for standardized biomarker protocols and personalized treatment strategies based on genetic predispositions and baseline oxidative status. Future research may better harness antioxidant interventions to improve maternal–fetal health by addressing these gaps. Full article

Gestational diabetes mellitus (GDM), a prevalent metabolic disorder in pregnancy, induces maternal hyperglycemia and elevates fetal malformation risks, particularly in craniofacial development. To investigate the underlying mechanisms, we employed zebrafish as a model organism due to its conserved skeletal development pathways with humans. Zebrafish embryos were exposed to 3.5% and 4% high glucose (HG) from 10–80 h post-fertilization (hpf). Through comprehensive analyses including Alcian blue staining, confocal microscopy, and molecular assays, we demonstrated that HG exposure caused significant developmental abnormalities including growth retardation, craniofacial cartilage malformations, and impaired cranial neural crest cells (CNCCs) migration and proliferation. Mechanistically, HG induced reactive oxygen species (ROS) accumulation and oxidative stress while downregulating critical CNCCs markers (dlx2 and tfap2a). These molecular alterations correlated with histomorphological defects in pharyngeal arch cartilage, particularly in ceratohyal formation. Our findings establish that glucose disrupts craniofacial development through oxidative stress-mediated CNCCs dysfunction, providing novel mechanistic insights into GDM-associated skeletal abnormalities and potential therapeutic targets. Full article

Gestational diabetes mellitus (GDM) is a frequently encountered medical complication during pregnancy that is increasing at a rapid pace globally, posing significant public health concerns. Similarly, there is a rising trend in the number of women who have utilized assisted reproductive technology (ART). Numerous studies have been carried out to investigate the relationship between GDM and ART. This comprehensive systematic review seeks to identify potential biomarkers for the early diagnosis of GDM in pregnancies conceived through ART. We conducted a PubMed search covering the past five years to identify studies that explore biomarkers associated with the development of GDM in pregnancies conceived through ART. The outcome measures included human chorionic gonadotropin (HCG), the body mass index (BMI), the Follicle Stimulating Hormone to Luteinizing Hormone (FSH/LH) ratio, increased hemoglobin A1c levels, fasting insulin concentrations, homeostatic model assessment of insulin resistance (HOMA-IR), triglyceride levels, total cholesterol levels, low-density lipoprotein cholesterol concentrations, low-density lipoprotein/high-density lipoprotein (LDL/HDL), total cholesterol to high-density lipoprotein (TC/HDL), the estradiol/follicle ratio, soluble fms-like tyrosine kinase-1 (sFlt-1), Placental Growth Factor (PLGF), endometrial thickness, and psychological stress. Seventeen studies were included. The identification and development of serum or ultrasound biomarkers for the early detection of GDM in pregnancies conceived through ART pose considerable challenges. These challenges arise from the multifactorial nature of GDM, the methodological variations in ART, and the limited availability of relevant studies. The most promising biomarker identified was the estradiol/follicle ratio. Women with a higher estradiol/follicle ratio exhibited significantly lower rates of GDM. There is a pressing necessity for biomarkers to enable the early detection of GDM in pregnancies conceived through ART. E2 levels, β-hCG, and the E2/F ratio, along with the TC/HDL and LDL/HDL ratios, show potential as reliable biomarkers for identifying GDM. Full article

Gestational complications, such as preeclampsia and gestational diabetes mellitus (GDM), pose significant risks to maternal and fetal health and increase long-term cardiovascular disease risk in offspring. This review aims to synthesize current knowledge on the roles of ferroptosis and neutrophil extracellular trap formation (NETosis)—two regulated cell death pathways—in these pregnancy-related conditions. We performed a comprehensive analysis of preclinical and clinical studies that investigate the involvement of dysregulated iron metabolism, oxidative stress, inflammation, and endothelial dysfunction mediated by ferroptosis and NETosis in gestational pathologies. Evidence indicates that disturbances in maternal iron homeostasis and enhanced formation of lipid peroxides and NETs contribute to placental dysfunction and systemic inflammation, exacerbating disease severity. Therapeutic strategies targeting these pathways are emerging but require further validation. Our review also identifies key gaps in mechanistic understanding, biomarker development, and translational research needs. We conclude that modulation of ferroptosis and NETosis offers promising avenues for improving diagnosis and treatment of pregnancy complications, though carefully designed clinical studies are essential to confirm their clinical utility and safety. Full article

Background/Objectives: Gestational diabetes mellitus (GDM) is a state of hyperglycemia during pregnancy, increasing the risk of birth complications, and subsequent type 2 diabetes mellitus in the mother and offspring. Risk factors such as diet, obesity, and family history have demonstrated strong association with GDM, but no clear pathophysiology has been ascertained. Methods: An analysis was conducted on 38 women with and 296 without GDM, within a case/control study of pre-eclampsia. The genetic variants examined were selected from among a published polygenic risk score of 10 variants (PRS-10). Genetic models were evaluated for each variant by multivariate logistic regression methods adjusted for age, body mass index, and pre-eclampsia. Since the genotypes for three of the PRS-10 were not available, a risk score comprising the total risk alleles among seven of the variants (PRS-7) was evaluated among those with all genotypes available. Results: Multivariate logistic regression showed significant, independent, positive associations between body mass index (BMI) and age. The posited PRS-7 showed a trend (OR 1.56, 95% CI 0.92–2.56, p = 0.070), and sensitivity analysis comprising three variants (PRS-3) was significantly associated with GDM (OR 2.43, 95% CI 1.17–5.06, p = 0.017). In univariate analysis, rs1421085 was associated with GDM (OR 0.50, 95% CI 0.26–0.95, p = 0.034), but not after adjustment for covariates, and paradoxically not for the expected risk allele. None of the other six variants showed an individual association with GDM. The previously published meta-analysis of PRS-10 showed a degree of heterogeneity (p_Q= 0.03) among the three cohorts analyzed, suggesting that variant effects may differ according to the genetic background, which points to the importance of examining the generalizability of any posited polygenic risk scores. Conclusions: In conclusion, we provide additional support for and further refine the results of a previously published polygenic risk score for GDM in an ethically unrelated population. Full article

Background/Objectives: Gestational diabetes mellitus (GDM) complicates approximately 14% of pregnancies worldwide, its prevalence rising with increasing maternal age and obesity. While maternal hyperglycemia is traditionally associated with fetal overgrowth and large-for-gestational-age (LGA) neonates, emerging evidence indicates that GDM may also contribute to small-for-gestational-age (SGA) outcomes. Methods: A comprehensive literature search was conducted using multiple databases, including PubMed, Web of Science, and ScienceDirect, to identify studies related to gestational diabetes mellitus, fetal growth outcomes such as small for gestational age and large for gestational age, and associated pathophysiological mechanisms. Results: This narrative review explores the mechanisms by which GDM influences fetal growth, emphasizing the dual risk of excessive and restricted intrauterine growth. Fetal macrosomia typically results from chronic maternal hyperglycemia, leading to increased transplacental glucose delivery and fetal hyperinsulinemia. In contrast, SGA outcomes are a consequence of vascular and endothelial dysfunction, placental insufficiency, or excessively restrictive glycemic control that limit the availability of nutrients. Both extremes of fetal growth carry a myriad of significant perinatal and long-term metabolic risks. Conclusions: Understanding the diverse pathways through which GDM affects fetal growth is essential for developing individualized clinical strategies. Full article

Gestational diabetes mellitus (GDM) affects approximately 14% of pregnancies globally and has been hypothesized to be influenced by periconceptional and early pregnancy folic acid (FA) supplementation, a practice recommended to prevent neural tube defects. To evaluate this association, we conducted a systematic review of studies published between 2015 and 2024 examining FA use and GDM risk. Twelve studies met the inclusion criteria, including ten cohort studies and two case-control studies. While findings were mixed, several prospective studies suggested that high daily FA intake (≥800 μg) or prolonged use (>3–6 months) may be associated with increased odds of GDM, especially when initiated preconceptionally. Conversely, standard-dose supplementation (≈400 μg) appeared neutral or potentially protective in some populations. Notably, high folate status combined with low vitamin B12 was linked to increased GDM risk, suggesting metabolic interaction. Overall, most studies were of moderate to high methodological quality. Although current evidence is inconclusive, these results support cautious use of high-dose FA supplementation and the importance of individualized prenatal nutrition, particularly considering B12 status. Further research is needed to clarify biological mechanisms. Full article

Objective: To assess gestational diabetes mellitus (GDM) awareness among women in the Northern Borders Province of Saudi Arabia and identify factors associated with knowledge levels. Methods: A cross-sectional study was conducted among 461 women using a structured, validated online questionnaire assessing demographics, medical history, and knowledge of GDM’s effects on maternal and neonatal outcomes. Associations between demographic factors and GDM awareness were analyzed using chi-square tests. Results: Most participants (98.5%) were Saudi nationals, with a mean age of 34.5 ± 10.0 years; 82.6% had university-level education. Overall, 42.3% demonstrated fair awareness of GDM, 34.3% had good awareness, and 23.4% had poor awareness. Knowledge of GDM’s maternal complications varied: 70% recognized the risk of emergency cesarean section, but only 8.2% were aware of increased preeclampsia risk. For neonatal outcomes, 58.4% identified high birth weight as a risk, while only 31.9% recognized the risk of congenital anomalies. Higher awareness was significantly associated with education level (p = 0.02), pregnancy status (p = 0.001), trimester (p = 0.002), and family history of relevant conditions (p = 0.04). Conclusion: Although many women showed fair-to-good awareness of GDM, notable gaps remain, especially regarding specific complications. Targeted educational interventions, particularly for less-educated and non-pregnant women, are recommended to improve GDM awareness and pregnancy outcomes. Full article

Background and Objectives: Gestational diabetes mellitus (GDM), which is becoming increasingly common in contemporary society, is recognized for its considerable psychosocial impact on pregnant women throughout the perinatal phase. The purpose of this research was to explore the possible links between mental health status and dietary habits among pregnant women diagnosed with GDM, alongside examining how these factors correlate with clinical indicators like HbA1c measurements and the necessity for insulin therapy. Materials and Methods: The study included 82 pregnant participants, 37 with gestational diabetes mellitus and 45 without. Blood samples were collected from all participants for biochemical analysis, including fasting blood glucose, postprandial blood glucose, and HbA1c levels, which can be clinical indicators for the presence of gestational diabetes mellitus, and the need for insulin treatment was recorded. Then, participants completed a questionnaire collecting sociodemographic and clinical data as well as the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Salzburg Emotional Eating Scale (SEES), and REZZY Eating Disorders Scale (REZZY). Data were statistically analyzed. Results: A previous diagnosis of gestational diabetes was more frequent in the case group (18.9%) than in the control group (2.2%) (p = 0.020). OGTT positivity was detected in 56.8% of the case group, whereas all control participants had negative results (p < 0.001). There were no statistically significant differences between the two groups in psychological symptom scores or eating behavior assessments (p > 0.05). Conclusions: Pregnant women with gestational diabetes mellitus were observed to score higher on measures of anxiety, depression, and emotional eating, particularly in response to negative emotions. These findings may indicate a potential association between gestational diabetes and psychological or behavioral factors related to metabolic regulation during pregnancy. Full article

The etiology of women with gestational diabetes mellitus (GDM) and a greater risk of developing type 2 diabetes (T2D) after delivery remains unknown. This study aimed to investigate the global gene expression in four postpartum women with previous GDM (pGDM), three with T2D, and three with a history of normoglycemic pregnancy (controls). Total RNA was extracted from whole blood between March and May 2020. Global mRNA expression was determined using an Affymetrix Human Gene 2.0 ST Array. The expression of the selected focused genes was validated by RT-PCR. The microarray revealed 140 transcripts (p < 0.05, fold change cut-off ≥ 2) in patients with pGDM compared to controls. We identified 583 gene-altered transcripts between patients with T2D and controls. Interestingly, 60 transcripts had genes shared by pGDM or T2D versus the controls. The selected upregulated genes involved in inflammatory response, glycosylation, and death-like domains, according to the functional network analysis of pGDM (TNFAIP6, PDK3) and T2D (MMP9 and CARD6), showed similar trends to those obtained via microarray. Thus, these differentially expressed genes and their corresponding network and pathway analyses in women with pGDM and T2D offer valuable insights into the possible biological mechanisms of the progression of GDM to T2D. Full article

Background/Objectives: While clinical guidelines recommend screening and treatment for gestational diabetes mellitus (GDM) between 24 and 28 weeks, the benefits of earlier diagnosis are emerging. The objective of this study was to evaluate whether the early diagnosis of GDM is associated with reduced excessive gestational weight gain (GWG). Methods: Cohort study that analyzed 4694 pregnant women diagnosed with GDM attending high-risk prenatal care services within the Brazilian Unified Health System in six Brazilian capitals. GWG was classified according to Brazilian-specific pregnancy recommendations. ANCOVA tests were used to compare mean differences in total GWG across the timing of diagnosis. The timing of GDM diagnosis and excessive GWG was further evaluated using linear and logistic regression analysis. Results: Among the 4694 women with GDM (mean age 31.7 ± 6.3 years; mean pre-pregnancy BMI 30.4 ± 6.5 kg/m², with 47.6% classified with obesity), those diagnosed in the first trimester (n = 1315) gained 2.29 kg less (95% CI: −2.87 to −1.71 kg) total GWG compared to the third trimester, adjusting for risk factors including pregestational weight. First-trimester GDM diagnosis was associated with 22% lower odds of experiencing excessive GWG (Odds Ratio [OR] = 0.78; 95% CI: 0.72–0.86), compared to the third trimester. Diagnoses before 20 weeks and before 24 weeks had 18% (OR = 0.82; 95% CI: 0.77–0.88) and 19% (OR = 0.81; 95% CI: 0.76–0.87) lower odds of excessive GWG. Conclusions: Early diagnosis of GDM, particularly during the first trimester, is associated with reduced GWG. Integrating earlier GDM screening into routine prenatal care could mitigate excessive GWG. Full article