{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T20:56:15Z","timestamp":1791665775560,"version":"4.3.4"},"reference-count":95,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,2,27]],"date-time":"2023-02-27T00:00:00Z","timestamp":1677456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Physiology"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>\n                      Maternal obesity and gestational diabetes mellitus (GDM) are associated with insulin resistance and health risks for mother and offspring. Obesity is also characterized by low\u2010grade inflammation, which in turn, impacts insulin sensitivity. The placenta secretes inflammatory cytokines and hormones that influence maternal glucose and insulin handling. However, little is known about the effect of maternal obesity, GDM and their interaction, on placental morphology, hormones and inflammatory cytokines. In a South African cohort of non\u2010obese and obese pregnant women with and without GDM, this study examined placental morphology using stereology, placental hormone and cytokine expression using real\u2010time PCR, western blotting and immunohistochemistry, and circulating TNF\u03b1 and IL\u20106 concentrations using ELISA. Placental expression of endocrine and growth factor genes was not altered by obesity or GDM. However,\n                      <jats:italic>LEPTIN<\/jats:italic>\n                      gene expression was diminished, syncytiotrophoblast TNF\u03b1 immunostaining elevated and stromal and fetal vessel IL\u20106 staining reduced in the placenta of obese women in a manner that was partly influenced by GDM status. Placental TNF\u03b1 protein abundance and maternal circulating TNF\u03b1 concentrations were reduced in GDM. Both maternal obesity and, to a lesser extent, GDM were accompanied by specific changes in placental morphometry. Maternal blood pressure and weight gain and infant ponderal index were also modified by obesity and\/or GDM. Thus, obesity and GDM have specific impacts on placental morphology and endocrine and inflammatory states that may relate to pregnancy outcomes. These findings may contribute to developing placenta\u2010targeted treatments that improve mother and offspring outcomes, which is particularly relevant given increasing rates of obesity and GDM worldwide.\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tjp15446-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Rates of maternal obesity and gestational diabetes (GDM) are increasing worldwide, including in low\u2010middle income countries (LMIC).<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Despite this, much of the work in the field is conducted in higher\u2010income countries.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>In a well\u2010characterised cohort of South African women, this study shows that obesity and GDM have specific impacts on placental structure, hormone production and inflammatory profile.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Moreover, such placental changes were associated with pregnancy and neonatal outcomes in women who were obese and\/or with GDM.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>The identification of specific changes in the placenta may help in the design of diagnostic and therapeutic approaches to improve pregnancy and neonatal outcomes with particular significant benefit in LMICs.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1113\/jp284139","type":"journal-article","created":{"date-parts":[[2023,2,27]],"date-time":"2023-02-27T20:00:31Z","timestamp":1677528031000},"page":"1287-1306","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":67,"title":["Obesity and gestational diabetes independently and collectively induce specific effects on placental structure, inflammation and endocrine function in a cohort of South African women"],"prefix":"10.1113","volume":"601","author":[{"given":"Ezekiel","family":"Musa","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Department of Medicine University of Cape Town  Cape Town South Africa"},{"name":"Department of Internal Medicine Kaduna State University  Kaduna Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esteban","family":"Salazar\u2010Petres","sequence":"additional","affiliation":[{"name":"Centre for Trophoblast Research, Department of Physiology Development and Neuroscience, University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afolake","family":"Arowolo","sequence":"additional","affiliation":[{"name":"Hair and Skin Research Laboratory, Division of Dermatology, Department of Medicine University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Levitt","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mushi","family":"Matjila","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda N.","family":"Sferruzzi\u2010Perri","sequence":"additional","affiliation":[{"name":"Centre for Trophoblast Research, Department of Physiology Development and Neuroscience, University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,27]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.7196\/SAMJ.2017.v107i6.12043"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2016.1199676"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1515\/jpm-2013-0343"},{"key":"e_1_2_5_5_1","unstructured":"Anon. 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