Inflammation in maternal obesity and gestational diabetes mellitus

- Inflammation occurs in maternal obesity and gestational diabetes mellitus (GDM).
- The placenta plays a key role in inflammation in obesity and GDM.
- Maternal inflammation may not equate to fetal inflammation.

BackgroundThe prevalence of maternal obesity is rising rapidly worldwide and constitutes a major obstetric problem, increasing mortality and morbidity in both mother and offspring. Obese women are predisposed to pregnancy complications such as gestational diabetes mellitus (GDM), and children of obese mothers are more likely to develop cardiovascular and metabolic disease in later life. Maternal obesity and GDM may be associated with a state of chronic, low-grade inflammation termed “metainflammation”, as opposed to an acute inflammatory response. This inflammatory environment may be one mechanism by which offspring of obese women are programmed to develop adult disorders.MethodsHerein we review the evidence that maternal obesity and GDM are associated with changes in the maternal, fetal and placental inflammatory profile.ResultsMaternal inflammation in obesity and GDM may not always be associated with fetal inflammation.ConclusionWe propose that the placenta 'senses' and adapts to the maternal inflammatory environment, and plays a central role as both a target and producer of inflammatory mediators. In this manner, maternal obesity and GDM may indirectly program the fetus for later disease by influencing placental function.