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Maternal Body Weight and Gestational Diabetes Differentially Influence Placental and Pregnancy Outcomes

Martino, J.; Sebert, S.; Segura, M. T.; García-Valdés, L.; Florido, J.; Padilla, M. C.; Marcos, A.; Rueda, R.; McArdle, H. J.; Budge, H.; Symonds, Michael E.; Campoy, C.

Authors

J. Martino

S. Sebert

M. T. Segura

L. García-Valdés

J. Florido

M. C. Padilla

A. Marcos

R. Rueda

H. J. McArdle

HELEN BUDGE HELEN.BUDGE@NOTTINGHAM.AC.UK
Professor of Neonatal Medicine

Michael E. Symonds

C. Campoy



Abstract

Context:

Maternal obesity and gestational diabetes mellitus (GDM) can both contribute to adverse neonatal outcomes. The extent to which this may be mediated by differences in placental metabolism and nutrient transport remains to be determined.

Objective:

Our objective was to examine whether raised maternal body mass index (BMI) and/or GDM contributed to a resetting of the expression of genes within the placenta that are involved in energy sensing, oxidative stress, inflammation, and metabolic pathways.

Methods:

Pregnant women from Spain were recruited as part of the “Study of Maternal Nutrition and Genetics on the Foetal Adiposity Programming” survey at the first antenatal visit (12–20 weeks of gestation) and stratified according to prepregnancy BMI and the incidence of GDM. At delivery, placenta and cord blood were sampled and newborn anthropometry measured.

Results:

Obese women with GDM had higher estimated fetal weight at 34 gestational weeks and a greater risk of preterm deliveries and cesarean section. Birth weight was unaffected by BMI or GDM; however, women who were obese with normal glucose tolerance had increased placental weight and higher plasma glucose and leptin at term. Gene expression for markers of placental energy sensing and oxidative stress, were primarily affected by maternal obesity as mTOR was reduced, whereas SIRT-1 and UCP2 were both upregulated. In placenta from obese women with GDM, gene expression for AMPK was also reduced, whereas the downstream regulator of mTOR, p70S6KB1 was raised.

Conclusions:

Placental gene expression is sensitive to both maternal obesity and GDM which both impact on energy sensing and could modulate the effect of either raised maternal BMI or GDM on birth weight.

Journal Article Type Article
Publication Date Jan 1, 2016
Journal The Journal of Clinical Endocrinology & Metabolism
Print ISSN 0021-972X
Electronic ISSN 1945-7197
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 101
Issue 1
Pages 59-68
APA6 Citation Martino, J., Sebert, S., Segura, M. T., García-Valdés, L., Florido, J., Padilla, M. C., …Campoy, C. (2016). Maternal Body Weight and Gestational Diabetes Differentially Influence Placental and Pregnancy Outcomes. Journal of Clinical Endocrinology and Metabolism, 101(1), 59-68. https://doi.org/10.1210/jc.2015-2590
DOI https://doi.org/10.1210/jc.2015-2590
Publisher URL http://press.endocrine.org/doi/10.1210/jc.2015-2590
Copyright Statement Copyright information regarding this work can be found at the following address: http://eprints.nottingh.../end_user_agreement.pdf

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Martino et al JCEM revision Sept 2015 Final accepted version.pdf (797 Kb)
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Copyright Statement
Copyright information regarding this work can be found at the following address: http://eprints.nottingham.ac.uk/end_user_agreement.pdf





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