{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T12:44:33Z","timestamp":1791377073617,"version":"4.3.2"},"reference-count":66,"publisher":"American Diabetes Association","issue":"5","license":[{"start":{"date-parts":[[2019,4,22]],"date-time":"2019-04-22T00:00:00Z","timestamp":1555891200000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/www.diabetesjournals.org\/content\/license"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,5,1]]},"abstract":"<jats:p>Pregnancy has been equated to a \u201cstress test\u201d in which placental hormones and growth factors expose a mother\u2019s predisposition toward metabolic disease, unleashing her previously occult insulin resistance (IR), mild \u03b2-cell dysfunction, and glucose and lipid surplus due to the formidable forces of pregnancy-induced IR. Although pregnancy-induced IR is intended to assure adequate nutrition to the fetus and placenta, in mothers with obesity, metabolic syndrome, or those who develop gestational diabetes mellitus, this overnutrition to the fetus carries a lifetime risk for increased metabolic disease. Norbert Freinkel, nearly 40 years ago, coined this excess intrauterine nutrient exposure and subsequent offspring developmental risk \u201cfuel-mediated teratogenesis,\u201d not limited to only excess maternal glucose. Our attempts to better elucidate the causes and mechanisms behind this double-edged IR of pregnancy, to metabolically characterize the intrauterine environment that results in changes in newborn body composition and later childhood obesity risk, and to examine potential therapeutic approaches that might target maternal metabolism are the focus of this article. Rapidly advancing technologies in genomics, proteomics, and metabolomics offer us innovative approaches to interrogate these metabolic processes in the mother, her microbiome, the placenta, and her offspring that contribute to a phenotype at risk for future metabolic disease. If we are successful in our efforts, the researcher, endocrinologist, obstetrician, and health care provider fortunate enough to care for pregnant women have the unique opportunity to positively impact health outcomes not only in the short term but in the long run, not just in one life but in two\u2014and possibly, for the next generation.<\/jats:p>","DOI":"10.2337\/dci18-0048","type":"journal-article","created":{"date-parts":[[2019,4,23]],"date-time":"2019-04-23T02:45:31Z","timestamp":1555987531000},"page":"718-726","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":50,"title":["Metabolic Culprits in Obese Pregnancies and Gestational Diabetes Mellitus: Big Babies, Big Twists, Big Picture"],"prefix":"10.2337","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8656-3995","authenticated-orcid":false,"given":"Linda A.","family":"Barbour","sequence":"first","affiliation":[{"name":"Divisions of Endocrinology, Metabolism and Diabetes and Maternal Fetal Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2019,4,15]]},"reference":[{"key":"2022031303280974700_B1","doi-asserted-by":"crossref","first-page":"2137","DOI":"10.2337\/dbi17-0011","article-title":"Developmental programming of obesity and diabetes in mouse, monkey, and man in 2018: where are we headed?","volume":"67","author":"Friedman","year":"2018","journal-title":"Diabetes"},{"key":"2022031303280974700_B2","doi-asserted-by":"crossref","first-page":"j1","DOI":"10.1136\/bmj.j1","article-title":"Obesity and pregnancy: mechanisms of short term and long term adverse consequences for mother and child","volume":"356","author":"Catalano","year":"2017","journal-title":"BMJ"},{"key":"2022031303280974700_B3","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.2337\/diab.29.12.1023","article-title":"Banting lecture 1980. Of pregnancy and progeny","volume":"29","author":"Freinkel","year":"1980","journal-title":"Diabetes"},{"key":"2022031303280974700_B4","article-title":"Insulin resistance in pregnancy: implications for mother and offspring","volume-title":"Insulin Resistance: Childhood Precursors to Adult Disease","author":"Hernandez","edition":"2nd ed"},{"key":"2022031303280974700_B5","doi-asserted-by":"crossref","first-page":"S105","DOI":"10.2337\/dc07-s201","article-title":"What is gestational diabetes?","volume":"30","author":"Buchanan","year":"2007","journal-title":"Diabetes Care"},{"key":"2022031303280974700_B6","article-title":"Metabolic changes in normal and obese pregnancies and in gestational diabetes","volume-title":"Diagnosis and Management of Diabetes During Pregnancy","author":"Barbour"},{"key":"2022031303280974700_B7","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1007\/s00125-016-3931-6","article-title":"The fetal glucose steal: an underappreciated phenomenon in diabetic pregnancy","volume":"59","author":"Desoye","year":"2016","journal-title":"Diabetologia"},{"key":"2022031303280974700_B8","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1515\/JPEM.2000.13.4.343","article-title":"The roles of placental growth hormone and placental lactogen in the regulation of human fetal growth and development","volume":"13","author":"Handwerger","year":"2000","journal-title":"J Pediatr Endocrinol Metab"},{"key":"2022031303280974700_B9","first-page":"1143","article-title":"Placental growth hormone (GH), GH-binding protein, and insulin-like growth factor axis in normal, growth-retarded, and diabetic pregnancies: correlations with fetal growth","volume":"85","author":"McIntyre","year":"2000","journal-title":"J Clin Endocrinol Metab"},{"key":"2022031303280974700_B10","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1067\/mob.2002.121256","article-title":"Human placental growth hormone causes severe insulin resistance in transgenic mice","volume":"186","author":"Barbour","year":"2002","journal-title":"Am J Obstet Gynecol"},{"key":"2022031303280974700_B11","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1210\/en.2003-1297","article-title":"Human placental growth hormone increases expression of the p85 regulatory unit of phosphatidylinositol 3-kinase and triggers severe insulin resistance in skeletal muscle","volume":"145","author":"Barbour","year":"2004","journal-title":"Endocrinology"},{"key":"2022031303280974700_B12","doi-asserted-by":"crossref","first-page":"37489","DOI":"10.1074\/jbc.M506967200","article-title":"Increased P85\u03b1 is a potent negative regulator of skeletal muscle insulin signaling and induces in vivo insulin resistance associated with growth hormone excess","volume":"280","author":"Barbour","year":"2005","journal-title":"J Biol Chem"},{"key":"2022031303280974700_B13","doi-asserted-by":"crossref","first-page":"S112","DOI":"10.2337\/dc07-s202","article-title":"Cellular mechanisms for insulin resistance in normal pregnancy and gestational diabetes","volume":"30","author":"Barbour","year":"2007","journal-title":"Diabetes Care"},{"key":"2022031303280974700_B14","doi-asserted-by":"crossref","first-page":"606","DOI":"10.2337\/db07-1356","article-title":"Increased skeletal muscle tumor necrosis factor-\u03b1 and impaired insulin signaling persist in obese women with gestational diabetes mellitus 1 year postpartum","volume":"57","author":"Friedman","year":"2008","journal-title":"Diabetes"},{"key":"2022031303280974700_B15","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1210\/jc.2010-2116","article-title":"Chronically increased S6K1 is associated with impaired IRS1 signaling in skeletal muscle of GDM women with impaired glucose tolerance postpartum","volume":"96","author":"Barbour","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"key":"2022031303280974700_B16","doi-asserted-by":"crossref","first-page":"356","DOI":"10.2337\/dc09-1196","article-title":"Hormonal and metabolic factors associated with variations in insulin sensitivity in human pregnancy","volume":"33","author":"McIntyre","year":"2010","journal-title":"Diabetes Care"},{"key":"2022031303280974700_B17","doi-asserted-by":"crossref","first-page":"E522","DOI":"10.1152\/ajpendo.00124.2001","article-title":"Downregulated IRS-1 and PPAR\u03b3 in obese women with gestational diabetes: relationship to FFA during pregnancy","volume":"282","author":"Catalano","year":"2002","journal-title":"Am J Physiol Endocrinol Metab"},{"key":"2022031303280974700_B18","doi-asserted-by":"crossref","first-page":"1677","DOI":"10.1007\/s00125-006-0264-x","article-title":"Adiponectin in human pregnancy: implications for regulation of glucose and lipid metabolism","volume":"49","author":"Catalano","year":"2006","journal-title":"Diabetologia"},{"key":"2022031303280974700_B19","doi-asserted-by":"crossref","first-page":"e106872","DOI":"10.1371\/journal.pone.0106872","article-title":"Gestational diabetes is characterized by reduced mitochondrial protein expression and altered calcium signaling proteins in skeletal muscle","volume":"9","author":"Boyle","year":"2014","journal-title":"PLoS One"},{"key":"2022031303280974700_B20","doi-asserted-by":"crossref","first-page":"2284","DOI":"10.1001\/jama.2016.6458","article-title":"Trends in obesity among adults in the United States, 2005 to 2014","volume":"315","author":"Flegal","year":"2016","journal-title":"JAMA"},{"key":"2022031303280974700_B21","doi-asserted-by":"crossref","first-page":"e112","DOI":"10.1097\/AOG.0000000000001211","volume":"126","author":"American College of Obstetricians and Gynecologists","year":"2015","journal-title":"Obstet Gynecol"},{"key":"2022031303280974700_B22","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.mcna.2017.08.008","article-title":"Obesity in pregnancy: optimizing outcomes for mom and baby","volume":"102","author":"Dutton","year":"2018","journal-title":"Med Clin North Am"},{"key":"2022031303280974700_B23","doi-asserted-by":"crossref","first-page":"1991","DOI":"10.1056\/NEJMoa0707943","article-title":"Hyperglycemia and adverse pregnancy outcomes","volume":"358","author":"Metzger","year":"2008","journal-title":"N Engl J Med"},{"key":"2022031303280974700_B24","first-page":"381","article-title":"Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study (HAPO FUS): maternal glycemia and childhood glucose metabolism. Diabetes Care","volume":"42","author":"Scholtens","year":"2019"},{"key":"2022031303280974700_B25","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.3945\/ajcn.2008.27416","article-title":"Perinatal risk factors for childhood obesity and metabolic dysregulation","volume":"90","author":"Catalano","year":"2009","journal-title":"Am J Clin Nutr"},{"key":"2022031303280974700_B26","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1586\/17446651.2014.991102","article-title":"Optimizing weight for maternal and infant health - tenable, or too late?","volume":"10","author":"Nicklas","year":"2015","journal-title":"Expert Rev Endocrinol Metab"},{"key":"2022031303280974700_B27","doi-asserted-by":"crossref","first-page":"780","DOI":"10.2337\/dc11-1790","article-title":"The Hyperglycemia and Adverse Pregnancy Outcome Study: associations of GDM and obesity with pregnancy outcomes","volume":"35","author":"Catalano","year":"2012","journal-title":"Diabetes Care"},{"key":"2022031303280974700_B28","doi-asserted-by":"crossref","first-page":"1660","DOI":"10.2337\/dc11-0241","article-title":"Patterns of glycemia in normal pregnancy: should the current therapeutic targets be challenged?","volume":"34","author":"Hernandez","year":"2011","journal-title":"Diabetes Care"},{"key":"2022031303280974700_B29","doi-asserted-by":"crossref","first-page":"2198","DOI":"10.2337\/dc11-0723","article-title":"Continuous glucose profiles in obese and normal-weight pregnant women on a controlled diet: metabolic determinants of fetal growth","volume":"34","author":"Harmon","year":"2011","journal-title":"Diabetes Care"},{"key":"2022031303280974700_B30","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1089\/dia.2012.0223","article-title":"A standard approach to continuous glucose monitor data in pregnancy for the study of fetal growth and infant outcomes","volume":"15","author":"Hernandez","year":"2013","journal-title":"Diabetes Technol Ther"},{"key":"2022031303280974700_B31","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1002\/oby.22246","article-title":"Postprandial triglycerides predict newborn fat more strongly than glucose in women with obesity in early pregnancy","volume":"26","author":"Barbour","year":"2018","journal-title":"Obesity (Silver Spring)"},{"key":"2022031303280974700_B32","first-page":"A397","article-title":"Early and late glycemic patterns in normal weight vs obese pregnancies: influence on neonatal adiposity (Poster 1485-P)","volume":"66","author":"Hernandez","year":"2017","journal-title":"Diabetes"},{"key":"2022031303280974700_B33","article-title":"Obstructive sleep apnea is associated with altered glycemic patterns in pregnant women with obesity","author":"Farabi","journal-title":"J Clin Endocrinol Metab"},{"key":"2022031303280974700_B34","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1016\/S0002-9378(99)70662-9","article-title":"Longitudinal changes in glucose metabolism during pregnancy in obese women with normal glucose tolerance and gestational diabetes mellitus","volume":"180","author":"Catalano","year":"1999","journal-title":"Am J Obstet Gynecol"},{"key":"2022031303280974700_B35","doi-asserted-by":"crossref","first-page":"1484","DOI":"10.2337\/dc13-1934","article-title":"Normalizing metabolism in diabetic pregnancy: is it time to target lipids?","volume":"37","author":"Barrett","year":"2014","journal-title":"Diabetes Care"},{"key":"2022031303280974700_B36","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1007\/s11892-018-1008-2","article-title":"Maternal non-glycemic contributors to fetal growth in obesity and gestational diabetes: spotlight on lipids","volume":"18","author":"Barbour","year":"2018","journal-title":"Curr Diab Rep"},{"key":"2022031303280974700_B37","doi-asserted-by":"crossref","first-page":"1256","DOI":"10.1111\/obr.12693","article-title":"Gestational dyslipidaemia and adverse birthweight outcomes: a systematic review and meta-analysis","volume":"19","author":"Wang","year":"2018","journal-title":"Obes Rev"},{"key":"2022031303280974700_B38","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1007\/s11892-018-0978-4","article-title":"Implications of lipids in neonatal body weight and fat mass in gestational diabetic mothers and non-diabetic controls","volume":"18","author":"Herrera","year":"2018","journal-title":"Curr Diab Rep"},{"key":"2022031303280974700_B39","doi-asserted-by":"crossref","first-page":"1638","DOI":"10.1016\/j.clinthera.2018.08.007","article-title":"Maternal lipids and fetal overgrowth: making fat from fat","volume":"40","author":"Barbour","year":"2018","journal-title":"Clin Ther"},{"key":"2022031303280974700_B40","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.placenta.2018.03.001","article-title":"Placental lipoprotein lipase activity is positively associated with newborn adiposity","volume":"64","author":"Heerwagen","year":"2018","journal-title":"Placenta"},{"key":"2022031303280974700_B41","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1080\/07315724.1990.10720387","article-title":"Dietary manipulation as a primary treatment strategy for pregnancies complicated by diabetes","volume":"9","author":"Jovanovic-Peterson","year":"1990","journal-title":"J Am Coll Nutr"},{"key":"2022031303280974700_B42","doi-asserted-by":"crossref","first-page":"82","DOI":"10.2337\/diaspect.29.2.82","article-title":"Carbohydrate content in the GDM diet: two views: view 1: nutrition therapy in gestational diabetes: the case for complex carbohydrates","volume":"29","author":"Hernandez","year":"2016","journal-title":"Diabetes Spectr"},{"key":"2022031303280974700_B43","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.diabres.2018.04.004","article-title":"Nutrition therapy within and beyond gestational diabetes","volume":"145","author":"Hernandez","year":"2018","journal-title":"Diabetes Res Clin Pract"},{"key":"2022031303280974700_B44","doi-asserted-by":"crossref","first-page":"S251","DOI":"10.2337\/dc07-s225","article-title":"Summary and recommendations of the Fifth International Workshop-Conference on Gestational Diabetes Mellitus","volume":"30","author":"Metzger","year":"2007","journal-title":"Diabetes Care"},{"key":"2022031303280974700_B45","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.2337\/dc13-2411","article-title":"A higher-complex carbohydrate diet in gestational diabetes mellitus achieves glucose targets and lowers postprandial lipids: a randomized crossover study","volume":"37","author":"Hernandez","year":"2014","journal-title":"Diabetes Care"},{"key":"2022031303280974700_B46","doi-asserted-by":"crossref","first-page":"39","DOI":"10.2337\/dc15-0515","article-title":"Women with gestational diabetes mellitus randomized to a higher-complex carbohydrate\/low-fat diet manifest lower adipose tissue insulin resistance, inflammation, glucose, and free fatty acids: a pilot study","volume":"39","author":"Hernandez","year":"2016","journal-title":"Diabetes Care"},{"key":"2022031303280974700_B47","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.2337\/dci18-0014","article-title":"Nutrition therapy in gestational diabetes mellitus: time to move forward","volume":"41","author":"Hernandez","year":"2018","journal-title":"Diabetes Care"},{"key":"2022031303280974700_B48","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1111\/ijpo.12055","article-title":"Striking differences in estimates of infant adiposity by new and old DXA software, PEAPOD and skin-folds at 2 weeks and 1 year of life","volume":"11","author":"Barbour","year":"2016","journal-title":"Pediatr Obes"},{"key":"2022031303280974700_B49","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1002\/ajhb.22500","article-title":"Body composition assessment in the infant","volume":"26","author":"Demerath","year":"2014","journal-title":"Am J Hum Biol"},{"key":"2022031303280974700_B50","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1016\/j.jpeds.2012.11.017","article-title":"Intrahepatic fat is increased in the neonatal offspring of obese women with gestational diabetes","volume":"162","author":"Brumbaugh","year":"2013","journal-title":"J Pediatr"},{"key":"2022031303280974700_B51","article-title":"Maternal triglycerides in gestational diabetes are strongly associated with increased newborn hepatic fat independent of subcutaneous fat (Abstract)","author":"Hernandez","year":"","journal-title":"Diabetes"},{"key":"2022031303280974700_B52","first-page":"323","article-title":"Maternal high-fat diet triggers lipotoxicity in the fetal livers of nonhuman primates","volume":"119","author":"McCurdy","year":"2009","journal-title":"J Clin Invest"},{"key":"2022031303280974700_B53","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1038\/pr.2013.193","article-title":"Developmental origins of nonalcoholic fatty liver disease","volume":"75","author":"Brumbaugh","year":"2014","journal-title":"Pediatr Res"},{"key":"2022031303280974700_B54","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.2337\/dc15-2672","article-title":"Heterogeneous contribution of insulin sensitivity and secretion defects to gestational diabetes mellitus","volume":"39","author":"Powe","year":"2016","journal-title":"Diabetes Care"},{"key":"2022031303280974700_B55","doi-asserted-by":"crossref","first-page":"902","DOI":"10.2337\/dc16-2452","article-title":"Maternal BMI and glycemia impact the fetal metabolome","volume":"40","author":"Lowe","year":"2017","journal-title":"Diabetes Care"},{"key":"2022031303280974700_B56","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1159\/000463397","article-title":"Placental lipid and fatty acid transfer in maternal overnutrition","volume":"70","author":"Lewis","year":"2017","journal-title":"Ann Nutr Metab"},{"key":"2022031303280974700_B57","doi-asserted-by":"crossref","first-page":"209.e1","DOI":"10.1016\/j.ajog.2009.04.019","article-title":"Differential regulation of genes for fetoplacental lipid pathways in pregnancy with gestational and type 1 diabetes mellitus","volume":"201","author":"Radaelli","year":"2009","journal-title":"Am J Obstet Gynecol"},{"key":"2022031303280974700_B58","doi-asserted-by":"crossref","first-page":"12","DOI":"10.3389\/fphys.2016.00012","article-title":"Placental responses to changes in the maternal environment determine fetal growth","volume":"7","author":"Dimasuay","year":"2016","journal-title":"Front Physiol"},{"key":"2022031303280974700_B59","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1111\/dom.12495","article-title":"Prevention of gestational diabetes mellitus: where are we now?","volume":"17","author":"Simmons","year":"2015","journal-title":"Diabetes Obes Metab"},{"key":"2022031303280974700_B60","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/j.diabres.2018.02.036","article-title":"Development of a risk engine relating maternal glycemia and body mass index to pregnancy outcomes","volume":"139","author":"McIntyre","year":"2018","journal-title":"Diabetes Res Clin Pract"},{"key":"2022031303280974700_B61","doi-asserted-by":"crossref","first-page":"647","DOI":"10.2337\/db15-0849","article-title":"Mesenchymal stem cells from infants born to obese mothers exhibit greater potential for adipogenesis: the Healthy Start BabyBUMP Project","volume":"65","author":"Boyle","year":"2016","journal-title":"Diabetes"},{"key":"2022031303280974700_B62","doi-asserted-by":"crossref","first-page":"18095","DOI":"10.1038\/s41598-017-17588-4","article-title":"Altered gene expression and metabolism in fetal umbilical cord mesenchymal stem cells correspond with differences in 5-month-old infant adiposity gain","volume":"7","author":"Baker","year":"2017","journal-title":"Sci Rep"},{"key":"2022031303280974700_B63","doi-asserted-by":"crossref","first-page":"4462","DOI":"10.1038\/s41467-018-06929-0","article-title":"The gut microbiota in infants of obese mothers increases inflammation and susceptibility to NAFLD","volume":"9","author":"Soderborg","year":"2018","journal-title":"Nat Commun"},{"key":"2022031303280974700_B64","doi-asserted-by":"crossref","first-page":"233","DOI":"10.2337\/dci17-0031","article-title":"Diabetes in youth\u2014looking backwards to inform the future: Kelly West Award Lecture 2017","volume":"41","author":"Dabelea","year":"2018","journal-title":"Diabetes Care"},{"key":"2022031303280974700_B65","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1097\/MOP.0000000000000600","article-title":"Environmental influences on Child Health Outcomes, a research program of the National Institutes of Health","volume":"30","author":"Gillman","year":"2018","journal-title":"Curr Opin Pediatr"},{"key":"2022031303280974700_B66","doi-asserted-by":"crossref","first-page":"367.e1","DOI":"10.1016\/j.ajog.2018.06.013","article-title":"A cautionary response to SMFM statement: pharmacological treatment of gestational diabetes","volume":"219","author":"Barbour","year":"2018","journal-title":"Am J Obstet Gynecol"}],"container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/42\/5\/718\/553004\/dci180048.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/42\/5\/718\/553004\/dci180048.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,13]],"date-time":"2022-03-13T07:59:41Z","timestamp":1647158381000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/42\/5\/718\/40544\/Metabolic-Culprits-in-Obese-Pregnancies-and"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4,15]]},"references-count":66,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2019,4,15]]},"published-print":{"date-parts":[[2019,5,1]]}},"URL":"https:\/\/doi.org\/10.2337\/dci18-0048","relation":{},"ISSN":["0149-5992","1935-5548"],"issn-type":[{"value":"0149-5992","type":"print"},{"value":"1935-5548","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,4,15]]}}}