title: Maternal Body Weight and Gestational Diabetes Differentially Influence Placental and Pregnancy Outcomes.
abstract: BACKGROUND
  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.
authors.affiliation: Early Life Research Unit (J.M., S.S., H.B., M.E.S.), Division of Child Health and Obstetrics & Gynaecology, School of Medicine, University of Nottingham, Nottingham NG7 2UH, United Kingdom; EURISTIKOS Excellence Centre for Paediatric Research (J.M., M.T.S., L.G.-V., C.C.), University of Granada, 18016 Granada, Spain; Department of Obstetrics and Gynaecology (J.F., M.C.P.), University of Granada, Granada, Spain; Immunonutrition Research Group (A.M.), Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition, Spanish National Research Council, E-28040 Madrid, Spain; Abbott Nutrition (R.R.), 18004 Granada, Spain; The Rowett Institute of Nutrition and Health (H.J.M.), University of Bucksburn, Aberdeen, AB21 9SB,United Kingdom; Institute of Health Sciences and Biocenter Oulu (S.S.), University of Oulu, 90014 Oulu, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Martino
authors.affiliation: Early Life Research Unit (J.M., S.S., H.B., M.E.S.), Division of Child Health and Obstetrics & Gynaecology, School of Medicine, University of Nottingham, Nottingham NG7 2UH, United Kingdom; EURISTIKOS Excellence Centre for Paediatric Research (J.M., M.T.S., L.G.-V., C.C.), University of Granada, 18016 Granada, Spain; Department of Obstetrics and Gynaecology (J.F., M.C.P.), University of Granada, Granada, Spain; Immunonutrition Research Group (A.M.), Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition, Spanish National Research Council, E-28040 Madrid, Spain; Abbott Nutrition (R.R.), 18004 Granada, Spain; The Rowett Institute of Nutrition and Health (H.J.M.), University of Bucksburn, Aberdeen, AB21 9SB,United Kingdom; Institute of Health Sciences and Biocenter Oulu (S.S.), University of Oulu, 90014 Oulu, Finland.
authors.forename: S
authors.initials: S
authors.lastname: Sebert
authors.affiliation: Early Life Research Unit (J.M., S.S., H.B., M.E.S.), Division of Child Health and Obstetrics & Gynaecology, School of Medicine, University of Nottingham, Nottingham NG7 2UH, United Kingdom; EURISTIKOS Excellence Centre for Paediatric Research (J.M., M.T.S., L.G.-V., C.C.), University of Granada, 18016 Granada, Spain; Department of Obstetrics and Gynaecology (J.F., M.C.P.), University of Granada, Granada, Spain; Immunonutrition Research Group (A.M.), Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition, Spanish National Research Council, E-28040 Madrid, Spain; Abbott Nutrition (R.R.), 18004 Granada, Spain; The Rowett Institute of Nutrition and Health (H.J.M.), University of Bucksburn, Aberdeen, AB21 9SB,United Kingdom; Institute of Health Sciences and Biocenter Oulu (S.S.), University of Oulu, 90014 Oulu, Finland.
authors.forename: M T
authors.initials: MT
authors.lastname: Segura
authors.affiliation: Early Life Research Unit (J.M., S.S., H.B., M.E.S.), Division of Child Health and Obstetrics & Gynaecology, School of Medicine, University of Nottingham, Nottingham NG7 2UH, United Kingdom; EURISTIKOS Excellence Centre for Paediatric Research (J.M., M.T.S., L.G.-V., C.C.), University of Granada, 18016 Granada, Spain; Department of Obstetrics and Gynaecology (J.F., M.C.P.), University of Granada, Granada, Spain; Immunonutrition Research Group (A.M.), Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition, Spanish National Research Council, E-28040 Madrid, Spain; Abbott Nutrition (R.R.), 18004 Granada, Spain; The Rowett Institute of Nutrition and Health (H.J.M.), University of Bucksburn, Aberdeen, AB21 9SB,United Kingdom; Institute of Health Sciences and Biocenter Oulu (S.S.), University of Oulu, 90014 Oulu, Finland.
authors.forename: L
authors.initials: L
authors.lastname: García-Valdés
authors.affiliation: Early Life Research Unit (J.M., S.S., H.B., M.E.S.), Division of Child Health and Obstetrics & Gynaecology, School of Medicine, University of Nottingham, Nottingham NG7 2UH, United Kingdom; EURISTIKOS Excellence Centre for Paediatric Research (J.M., M.T.S., L.G.-V., C.C.), University of Granada, 18016 Granada, Spain; Department of Obstetrics and Gynaecology (J.F., M.C.P.), University of Granada, Granada, Spain; Immunonutrition Research Group (A.M.), Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition, Spanish National Research Council, E-28040 Madrid, Spain; Abbott Nutrition (R.R.), 18004 Granada, Spain; The Rowett Institute of Nutrition and Health (H.J.M.), University of Bucksburn, Aberdeen, AB21 9SB,United Kingdom; Institute of Health Sciences and Biocenter Oulu (S.S.), University of Oulu, 90014 Oulu, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Florido
authors.affiliation: Early Life Research Unit (J.M., S.S., H.B., M.E.S.), Division of Child Health and Obstetrics & Gynaecology, School of Medicine, University of Nottingham, Nottingham NG7 2UH, United Kingdom; EURISTIKOS Excellence Centre for Paediatric Research (J.M., M.T.S., L.G.-V., C.C.), University of Granada, 18016 Granada, Spain; Department of Obstetrics and Gynaecology (J.F., M.C.P.), University of Granada, Granada, Spain; Immunonutrition Research Group (A.M.), Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition, Spanish National Research Council, E-28040 Madrid, Spain; Abbott Nutrition (R.R.), 18004 Granada, Spain; The Rowett Institute of Nutrition and Health (H.J.M.), University of Bucksburn, Aberdeen, AB21 9SB,United Kingdom; Institute of Health Sciences and Biocenter Oulu (S.S.), University of Oulu, 90014 Oulu, Finland.
authors.forename: M C
authors.initials: MC
authors.lastname: Padilla
authors.affiliation: Early Life Research Unit (J.M., S.S., H.B., M.E.S.), Division of Child Health and Obstetrics & Gynaecology, School of Medicine, University of Nottingham, Nottingham NG7 2UH, United Kingdom; EURISTIKOS Excellence Centre for Paediatric Research (J.M., M.T.S., L.G.-V., C.C.), University of Granada, 18016 Granada, Spain; Department of Obstetrics and Gynaecology (J.F., M.C.P.), University of Granada, Granada, Spain; Immunonutrition Research Group (A.M.), Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition, Spanish National Research Council, E-28040 Madrid, Spain; Abbott Nutrition (R.R.), 18004 Granada, Spain; The Rowett Institute of Nutrition and Health (H.J.M.), University of Bucksburn, Aberdeen, AB21 9SB,United Kingdom; Institute of Health Sciences and Biocenter Oulu (S.S.), University of Oulu, 90014 Oulu, Finland.
authors.forename: A
authors.initials: A
authors.lastname: Marcos
authors.affiliation: Early Life Research Unit (J.M., S.S., H.B., M.E.S.), Division of Child Health and Obstetrics & Gynaecology, School of Medicine, University of Nottingham, Nottingham NG7 2UH, United Kingdom; EURISTIKOS Excellence Centre for Paediatric Research (J.M., M.T.S., L.G.-V., C.C.), University of Granada, 18016 Granada, Spain; Department of Obstetrics and Gynaecology (J.F., M.C.P.), University of Granada, Granada, Spain; Immunonutrition Research Group (A.M.), Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition, Spanish National Research Council, E-28040 Madrid, Spain; Abbott Nutrition (R.R.), 18004 Granada, Spain; The Rowett Institute of Nutrition and Health (H.J.M.), University of Bucksburn, Aberdeen, AB21 9SB,United Kingdom; Institute of Health Sciences and Biocenter Oulu (S.S.), University of Oulu, 90014 Oulu, Finland.
authors.forename: R
authors.initials: R
authors.lastname: Rueda
authors.affiliation: Early Life Research Unit (J.M., S.S., H.B., M.E.S.), Division of Child Health and Obstetrics & Gynaecology, School of Medicine, University of Nottingham, Nottingham NG7 2UH, United Kingdom; EURISTIKOS Excellence Centre for Paediatric Research (J.M., M.T.S., L.G.-V., C.C.), University of Granada, 18016 Granada, Spain; Department of Obstetrics and Gynaecology (J.F., M.C.P.), University of Granada, Granada, Spain; Immunonutrition Research Group (A.M.), Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition, Spanish National Research Council, E-28040 Madrid, Spain; Abbott Nutrition (R.R.), 18004 Granada, Spain; The Rowett Institute of Nutrition and Health (H.J.M.), University of Bucksburn, Aberdeen, AB21 9SB,United Kingdom; Institute of Health Sciences and Biocenter Oulu (S.S.), University of Oulu, 90014 Oulu, Finland.
authors.forename: H J
authors.initials: HJ
authors.lastname: McArdle
authors.affiliation: Early Life Research Unit (J.M., S.S., H.B., M.E.S.), Division of Child Health and Obstetrics & Gynaecology, School of Medicine, University of Nottingham, Nottingham NG7 2UH, United Kingdom; EURISTIKOS Excellence Centre for Paediatric Research (J.M., M.T.S., L.G.-V., C.C.), University of Granada, 18016 Granada, Spain; Department of Obstetrics and Gynaecology (J.F., M.C.P.), University of Granada, Granada, Spain; Immunonutrition Research Group (A.M.), Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition, Spanish National Research Council, E-28040 Madrid, Spain; Abbott Nutrition (R.R.), 18004 Granada, Spain; The Rowett Institute of Nutrition and Health (H.J.M.), University of Bucksburn, Aberdeen, AB21 9SB,United Kingdom; Institute of Health Sciences and Biocenter Oulu (S.S.), University of Oulu, 90014 Oulu, Finland.
authors.forename: H
authors.initials: H
authors.lastname: Budge
authors.affiliation: Early Life Research Unit (J.M., S.S., H.B., M.E.S.), Division of Child Health and Obstetrics & Gynaecology, School of Medicine, University of Nottingham, Nottingham NG7 2UH, United Kingdom; EURISTIKOS Excellence Centre for Paediatric Research (J.M., M.T.S., L.G.-V., C.C.), University of Granada, 18016 Granada, Spain; Department of Obstetrics and Gynaecology (J.F., M.C.P.), University of Granada, Granada, Spain; Immunonutrition Research Group (A.M.), Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition, Spanish National Research Council, E-28040 Madrid, Spain; Abbott Nutrition (R.R.), 18004 Granada, Spain; The Rowett Institute of Nutrition and Health (H.J.M.), University of Bucksburn, Aberdeen, AB21 9SB,United Kingdom; Institute of Health Sciences and Biocenter Oulu (S.S.), University of Oulu, 90014 Oulu, Finland.
authors.forename: M E
authors.initials: ME
authors.lastname: Symonds
authors.affiliation: Early Life Research Unit (J.M., S.S., H.B., M.E.S.), Division of Child Health and Obstetrics & Gynaecology, School of Medicine, University of Nottingham, Nottingham NG7 2UH, United Kingdom; EURISTIKOS Excellence Centre for Paediatric Research (J.M., M.T.S., L.G.-V., C.C.), University of Granada, 18016 Granada, Spain; Department of Obstetrics and Gynaecology (J.F., M.C.P.), University of Granada, Granada, Spain; Immunonutrition Research Group (A.M.), Department of Metabolism and Nutrition, Institute of Food Science and Technology and Nutrition, Spanish National Research Council, E-28040 Madrid, Spain; Abbott Nutrition (R.R.), 18004 Granada, Spain; The Rowett Institute of Nutrition and Health (H.J.M.), University of Bucksburn, Aberdeen, AB21 9SB,United Kingdom; Institute of Health Sciences and Biocenter Oulu (S.S.), University of Oulu, 90014 Oulu, Finland.
authors.forename: C
authors.initials: C
authors.lastname: Campoy
mesh_terms: D000293:Adolescent; D000328:Adult; D000886:Anthropometry; D001724:Birth Weight / Q000235:genetics; D015992:Body Mass Index; D001835:Body Weight; D016640:Diabetes, Gestational / Q000235:genetics / Q000503:physiopathology*; D002149:Energy Intake / Q000235:genetics; D005260:Female; D015870:Gene Expression / Q000235:genetics; D018149:Glucose Intolerance / Q000150:complications / Q000235:genetics; D006801:Humans; D007231:Infant, Newborn; D007249:Inflammation / Q000235:genetics / Q000473:pathology; D008137:Longitudinal Studies; D053858:Metabolic Networks and Pathways / Q000235:genetics; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000235:genetics; D018384:Oxidative Stress; D010920:Placenta / Q000378:metabolism / Q000503:physiopathology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D013030:Spain / Q000453:epidemiology; D055815:Young Adult