Does gestational diabetes mellitus influence the morphological characteristics of the placenta?

Authors

DOI:

https://doi.org/10.33448/rsd-v11i3.26851

Keywords:

Gestational; Diabetes; Placenta; Morphological and microscopic findings.

Abstract

Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance, with a decrease in insulin sensitivity during pregnancy, with recognition in the second or third trimester of pregnancy and disappearing after delivery. This mini-review is to provide a broad view of some recent studies that investigated the placental morphology in cases of maternal diagnosis of gestational diabetes. A literature search was carried out in PubMed, Medline, Google Scholar data sources, verifying the morphological characteristics of the placenta in situations of diagnosis of gestational diabetes, through prospective and observational studies, with the key terms “gestational diabetes”, “placenta” and ‘morphological”. We show, in table format, the studies carried out between 2015 and 2020 with the main placental morphological changes that reflect the condition of pregnant women with diabetes mellitus, the most considered in the literature, increase in placental weight and thickness. It was evident that there are still few studies on placental changes, requiring the encouragement of scientific productions on the approach. In conclusion, understanding the mechanism of placental development allows the assessment of changes when pregnant women are diagnosed with GDM, taking into account therapeutic strategies that can intervene in glycemic and metabolic control, in order to ensure maternal-fetal health.

References

ADA. American Diabetes Association. (2020). Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes — 2020. Diabetes Care, 43, (Suppl. S14–S31). https://doi.org/10.2337/dc20-S002.

Alejandro, E. U., Mamerto, T. P., Chung, G., Villavieja, A., Gaus, N. L., Morgan, E., & Pineda-Cortel, M. R. B. (2020). Gestational Diabetes Mellitus: A harbinger of the vicious cycle of diabetes. International Journal of Molecular Sciences, 21 (14), 01-21. https://doi.org/10.3390/ijms21145003.

Arshad R., Karim N., & Hasan J. A. (2014). Effects of insulin on placental, fetal and maternal outcomes in gestational diabetes mellitus. Pakistan Journal of Medical Sciences, 30 (2), 240-244. http://dx.doi.org/10.12669/pjms.302.4396.

Berceanu, C., Tetileanu, A. V., Ofiţeru, A. M., Brătilă, E., Mehedinţu, C., Voicu, N. L., Szasz, F. A., Berceanu, S., Vlădăreanu, S., & Navolan, D. B. (2018). Morphological and ultrasound findings in the placenta of diabetic pregnancy. Romanian Journal of Morphology Embryology, 59 (1), 175-186. https://pubmed.ncbi.nlm.nih.gov/29940626/.

Bianchi, C., Taricco, E., Cardellicchio, M., Mandò, C., Massari, M., Savasi, V., & Cetin, I. (2021). The role of obesity and gestational diabetes on placental size and fetal oxygenation. Placenta, 103, 59-63. https://doi.org/10.1016/j.placenta.2020.10.013.

Burton, J. G., & Jauniaux, E. (2015). What is placenta? American Journal of Obstetrics and Gynecology, 213 (4), (Suppl. S6-S8). https://doi.org/10.1016/j.ajog.2015.07.050.

Carrasco-Wong, I., Moller, A., Giachini, F. R., Lima, V. V., Toledo, F., Stojanova, J., Sobrevia, L., & Martín, S. S. (2020). Placental structure in gestational diabetes mellitus. Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease, 1866 (2), 01-10. https://doi.org/10.1016/j.bbadis.2019.165535.

Cho, N. H., Shaw, J. E., Karuranga, S., Huang Y., Fernandes, J. D. R., Ohlrogge, A. W., & Malanda, B. (2018). IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Research and Clinical Practice, 138, 271-281. https://doi.org/10.1016/j.diabres.2018.02.023.

Diabetes Canada Clinical Practice Guidelines Expert Committee, Punthakee Z, Goldenberg R, Katz P. (2018). Definition, Classification and Diagnosis of Diabetes, Prediabetes and Metabolic Syndrome. Can J Diabetes, 42 (1), 10-15. https://doi.org/10.1016/j.jcjd.2017.10.003.

Edu, A., Teodorescu, C., Dobjanschi, C. G., Socol, Z. Z., Teodorescu, V., Matei, A., Albu, D. F., & Radulian, G. (2016). Placenta changes in pregnancy with gestational diabetes. Romanian Journal of Morphology Embryology, 57 (2), 507-512. https://pubmed.ncbi.nlm.nih.gov/27516026/.

Egan, A. M. & Dinneen, S. F. (2018). What is diabetes? Medicine, 47 (1), 1-4. https://doi.org/10.1016/j.mpmed.2018.10.002.

Ehlers, E., Talton, O. O., Schust, D. J., & Schulz, L. C. (2021). Placental structural abnormalities in gestational diabetes and when they develop: A scoping review. Placenta., 116, 58-66. https://doi.org/10.1016/j.placenta.2021.04.005.

Forouhi, N. G., & Wareham, N. J. (2019). Epidemiology of diabetes. Diabetes: Basic facts, 47 (1), 22-27. https://doi.org/10.1016/j.mpmed.2018.10.004.

Gauster, M., Desoye, G., Tötsch, M., & Hiden, U. (2012). The placenta and gestational diabetes mellitus. Current Diabetes Reports, 12 (1), 16-23. https://doi.org/10.1007/s11892-011-0244-5.

Huynh, J., Dawson, D., Roberts, D., & Bentley-Lewis, R. (2015). A systematic review of placental pathology in maternal diabetes mellitus. Placenta, 36 (2), 101-114. https://doi.org/10.1016/j.placenta.2014.11.021.

Istrate-Ofiteru, A. M., Berceanu, C., Berceanu, S., Busuioc, C. J., Rosu G. C., Ditescu D., Grosu, F., & Voicu, N. L. (2020). The influence of gestational diabetes mellitus (GDM) and gestational hypertension (GH) on placental morphological changes. Romanian Journal of Morphology Embryology, 61 (2), 371-384. https://doi.org/10.47162/rjme.61.2.07.

Li J, Wu H, Liu Y, Yang L. (2020). High fat diet induced obesity model using four strains of mice: Kunming, C57BL/6, BALB/c and ICR. Exp Anim., 69 (3), 326–335. https://doi.org/10.1538/expanim.19-0148.

Kadivar, M., Khamseh, M. E., Malek, M., Khajavi, A., Noohi, A. H., & Najafi, L. (2020). Histomorphological changes of the placenta and umbilical cord in pregnancies complicated by gestational diabetes mellitus. Placenta, 97, 71-78. https://doi.org/10.1016/j.placenta.2020.06.018.

Malathi, B. G., & Ashok, M. (2019). The study on morphology of placenta in gestational diabetes mellitus. IP Archives of Cytology and Histopathology Research, 6 (4), 253–258. https://doi.org/10.18231/j.achr.2019.047.

Mbanya, J. C., & Mba, C. M. (2021). Centenary of the discovery of insulin: People with diabetes in Africa still have poor access to insulin. EClinical Medicine, 30 (34), 1-2. doi: 10.1016/j.eclinm.2021.100809.

Oppenheimer, D. C., Mazaheri, P., Ballard, D.H., Yano, M., & Fowler, K. J. (2019). Magnetic resonance imaging of the placenta and gravid uterus: a pictorial essay. Abdominal Radiology, 44 (2), 669-684. https://doi.org/10.1007/s00261-018-1755-1.

Plows, J. F., Stanley, J. L., Baker, P. N., Reynolds, C. M., & Vickers, M. H. (2018). The Pathophysiology of Gestational Diabetes Mellitus. International journal of molecular sciences, 19(11), 3342. https://doi.org/10.3390/ijms19113342

Pooransari, P., Ebrahimi, A., Nazemi, N., Yaminifar, F., & Abediasl, Z. (2020). Is gross morphology of placenta, umbilical cord, and neonatal outcome in well-controlled gestational diabetes mellitus pregnancy different? A case-control study. International Journal of Reproductive BioMedicine, 18 (6), 407–414. https://doi.org/10.18502/ijrm.v13i6.7282.

Ramírez-Emiliano, J., Fajardo-Araujo, M. E., Zúñiga-Trujillo, I., Pérez-Vázquez, V., Sandoval-Salazar, C., & Órnelas-Vázquez, J. K. (2017). Mitochondrial content, oxidative, and nitrosative stress in human full-term placentas with gestational diabetes mellitus. Reproductive Biology of Endocrinology, 15 (26), 01-08. https://doi.org/10.1186/s12958-017-0244-7.

Saeedi, P., Petersohn, I., Salpea P., Malanda B., Karuranga S., Unwin N., Colagiuri S., Guariguata L., Motala A. A., Ogurtsova K., Shaw J. E., Bright D., & Williams, R. (2019). Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Research and Clinical Practice, 157, 01-10. https://doi.org/10.1016/j.diabres.2019.107843.

Saini, P., Pankaj, J. P., Jain, A., Agarwal, G. C. (2015). Effect of gestational diabetes mellitus on gross morphology of placenta: a comparative study. International Journal of Anatomy and Research, 3 (1), 889-894. http://dx.doi.org/10.16965/ijar.2015.11.

Silini, A. R., Di Pietro, R., Lang-Olip, I., Alviano, F., Banerjee, A., Basile, M., Borutinskaite, V., Eissner, G., Gellhaus, A., Giebel, B., Huang Y., Janev, A.,Kreft, M. E., Kupper N., Abadía-Molina, A. C., Olivares E. G., Pandolfi A., Papait, A., Pozzobon M., … Parolini, O. (2020). Perinatal Derivatives: Where Do We Stand? A Roadmap of the Human Placenta and Consensus for Tissue and Cell Nomenclature. Frontiers in bioengineering and biotechnology, 8, 01-33. https://doi.org/10.3389/fbioe.2020.610544.

Turco, M. Y., & Moffett, A. (2019). Development of placenta. Development, 146 (22), 01-14. https://doi.org/10.1242/dev.163428.

Vecchio, I., Tornali, C., Bragazzi, N. L., & Martini, M. (2018). The Discovery of Insulin: An Important Milestone in the History of Medicine. Frontiers in Endocrinology (Lausanne), 23 (9), 1-8. https://doi.org/10.3389/fendo.2018.00613.

Yi-xiao, L., Deng-lu, L., Jia, L., Di, Q., Jingyun, W., Xin, C., Xuesong, Y., Rui-man, L., & Guang, W. (2020). Gestational diabetes mellitus in women increased the risk of neonatal infection via inflammation and autophagy in the placenta. Medicine, 99 (40), 01-10. http://dx.doi.org/10.1097/MD.0000000000022152.

Zaugg, J., Melhem, H., Huang, X., Wegner, M., Baumann, M., Surbek, D., Körner, M., & Albrecht, C. Gestational diabetes mellitus affects placental iron homeostasis: Mechanism and clinical implications. The FASEB Journal, 34, 7311-7329. https://doi.org/10.1096/fj.201903054R.

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Published

08/03/2022

How to Cite

SOUZA, D. G. de .; MENEZES, L. S. .; MACEDO, T. E. de; OLIVEIRA, G. R. .; BRANDÃO, V. P. .; MARTINS, M. das N.; COSTA, N. B. M. .; SILVA, F. de M. da; MORAIS, J. A. V. .; PACHECO, T. J. A. Does gestational diabetes mellitus influence the morphological characteristics of the placenta?. Research, Society and Development, [S. l.], v. 11, n. 3, p. e57311326851, 2022. DOI: 10.33448/rsd-v11i3.26851. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/26851. Acesso em: 19 nov. 2024.

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Review Article