Maternal obesity has a greater impact on the formation of the placenta, than gestational diabetes mellitus, GDM- a condition characterised by poor glucose control in pregnancy, a new study has found.
The finding, which was revealed in a study, published in The Journal of Physiology, advances knowledge of the processes driving unfavorable pregnancy outcomes and the ensuing increased risk of unfavourable neonatal and child health. The discovery of specific placental alterations may pave the way for the creation of future medicines or screening procedures that are specifically directed at the placenta and may enhance maternal and fetal health, especially in low- and middle-income nations.
The study, which was carried out by South African and English scientists in collaboration, is the first to look at the effects of maternal obesity and GDM at the same time and to be conducted in a nation with a low-middle income, where obesity and GDM during pregnancy have a significant negative impact on both health and the economy. Past research have only been conducted in high-income nations and have only looked into obesity and GDM separately.
Globally, the prevalence of obesity and GDM—the occurrence of impaired glucose control during pregnancy—is rising. Both have been connected to a number of maternal and fetal issues, including a greater risk of fetal mortality, stillbirth, infant death, and low birth weight in the baby. The cause of these problems is unknown.
The capacity of the placenta to distribute nutrients between the mother and developing child was discovered to be lessened by maternal obesity than by gestational diabetes mellitus (GDM). Inflammation indicators and placental hormone synthesis are both impacted by GDM and obesity, indicating that the placenta is really behaving improperly.
71 women of mixed or black ancestry were examined in the research. 52 of them were obese, and 38 of them had GDM. In order to assess the impact of obesity and GDM on this group of pregnant women, the researchers performed the study utilising clinical profiling, in-depth structural examination and molecular analysis of the placenta, and biochemical measures of maternal and newborn cord blood.
Lead author Professor Amanda Sferruzzi-Perri of the University of Cambridge said, “For the first time we have looked at the effects of both obesity and GDM on the placenta in black and mixed-ancestry woman, who are an understudied group, and what effect that these conditions might have on them and their children. It was important to discover that obesity has more of an influence than GDM on pregnancy outcomes for both the mother and the child”.
The study's main disadvantage is the limited sample size of just 71 women, which made it impossible to ascertain the effect of the fetus' gender on these placental alterations. Women who would be classified as overweight were also included in the non-obese category of women. The influence of the fetus' gender will be investigated in additional studies on obese, overweight, and lean mothers with and without GDM. In order to predict pregnancy outcomes and the long-term health of the fetus, researchers are interested in examining the interactions between obesity, GDM, and therapies such the blood glucose-lowering medicine metformin.
Lead co-author Professor Mushi Matjila of the University of Cape Town said, “South Africa is burdened by a quadruple disease burden of communicable and non-communicable disease, along with high maternal and child morbidity and mortality, and deaths related to violence and injuries. Additionally, we have one of the highest rates of female obesity globally, which undoubtedly fuels the non-communicable disease burden and contributes to maternal, neonatal and child morbidity.
As obesity and GDM often coexist, the study highlights the importance of obesity over GDM in modulating placental structure and function, and begins to piece together how these placental changes may explain observed complications (e.g., intrauterine death and stillbirths) and increased future non-communicable disease risk for both mother and baby.”
