{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T21:53:45Z","timestamp":1775685225964,"version":"3.50.1"},"reference-count":208,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell Dev. Biol."],"abstract":"<jats:p>\n                    Fetal overgrowth, manifesting as large for gestational age or macrosomia, remains a common complication of gestational diabetes mellitus (GDM) with neonatal and long-term metabolic implications. While maternal hyperglycemia is a key driver, evidence describes the role of dysregulated placental nutrient transport involving glucose, amino acids, and lipids mediated by signaling hubs like mTOR, IGF, and AMPK. Beyond traditional metabolic axes, this review explores emerging contributors, including gut microbiota dysbiosis and extracellular vesicle mediated communication, which modulate the environment. We synthesize evidence on fetal vascular adaptations and epigenetic programming underpinning accelerated growth. Clinically, achieving euglycemia often fails to eliminate residual overgrowth risks completely. Management is evolving to integrate advanced ultrasonic markers, such as fetal abdominal fat layer thickness, and pharmacotherapeutic candidates like metformin or pravastatin. However, addressing critical knowledge gaps requires robust longitudinal cohorts and rigorous causal inference to validate complex mechanisms. Furthermore, implementing standardized biomarker protocols remains essential for clinical translation. This review provides a comprehensive framework for precision-based strategies to manage GDM-related fetal overgrowth effectively. Search Strategy. A systematic search of PubMed, Web of Science, and Google Scholar was conducted for literature published up to 2025. The search utilized a combination of the following keywords and their variants: \u201cgestational diabetes mellitus,\u201d \u201cfetal overgrowth,\u201d \u201cmacrosomia,\u201d \u201cplacental transport,\u201d \u201cinsulin resistance,\u201d \u201cmTOR,\u201d \u201cextracellular vesicles,\u201d \u201cmicrobiome,\u201d and \u201cepigenetics.\u201d Boolean operators (AND, OR) were applied. Priority was given to human clinical studies, meta-analyses, and large cohort studies, with animal and\n                    <jats:italic>in vitro<\/jats:italic>\n                    experiments included as mechanistic supplements.\n                  <\/jats:p>","DOI":"10.3389\/fcell.2026.1744305","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T06:29:12Z","timestamp":1770100152000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Unraveling the complex web: pathogenesis and prevention of gestational diabetes mellitus-related fetal overgrowth"],"prefix":"10.3389","volume":"14","author":[{"given":"Xin-Yue","family":"Jiang","sequence":"first","affiliation":[{"name":"Department of Histology and Embryology, Zunyi Medical University","place":["Zunyi, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deng-Wang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Histology and Embryology, Zunyi Medical University","place":["Zunyi, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tao","family":"Duan","sequence":"additional","affiliation":[{"name":"Department of Histology and Embryology, Zunyi Medical University","place":["Zunyi, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji-dong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Immunology, Zunyi Medical University","place":["Zunyi, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan-Ping","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Histology and Embryology, Zunyi Medical University","place":["Zunyi, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Histology and Embryology, Zunyi Medical University","place":["Zunyi, Guizhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1016\/j.placenta.2022.07.013","article-title":"The LDL receptor: traffic and function in trophoblast cells under normal and pathological conditions","volume":"127","author":"Aguilera-Olgu\u00edn","year":"2022","journal-title":"Placenta"},{"key":"B2","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1111\/1471-0528.16013","article-title":"Pravastatin for early-onset pre-eclampsia: a randomised, blinded, placebo-controlled trial","volume":"127","author":"Ahmed","year":"2020","journal-title":"BJOG"},{"key":"B3","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1159\/000098157","article-title":"Macrosomic newborns of diabetic mothers are associated with increased aortic intima-media thickness and lipid concentrations","volume":"67","author":"Akcakus","year":"2006","journal-title":"Hormone Res."},{"key":"B4","doi-asserted-by":"publisher","first-page":"18981","DOI":"10.1038\/s41598-025-03879-8","article-title":"Role of galectin-9 in the development of gestational diabetes mellitus","volume":"15","author":"Albuayjan","year":"2025","journal-title":"Sci. Rep."},{"key":"B5","doi-asserted-by":"publisher","first-page":"399","DOI":"10.15537\/smj.2015.4.10307","article-title":"Gestational diabetes mellitus","volume":"36","author":"Alfadhli","year":"2015","journal-title":"Saudi Med. J."},{"key":"B6","doi-asserted-by":"publisher","first-page":"S282","DOI":"10.2337\/dc24-S015","article-title":"15. Management of diabetes in pregnancy: standards of care in Diabetes-2024","volume":"47","year":"2024","journal-title":"Diabetes Care"},{"key":"B7","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1186\/s12884-022-04767-z","article-title":"Sex-dependent influence of maternal predictors on fetal anthropometry in pregnancies with gestational diabetes mellitus","volume":"22","author":"Antoniou","year":"2022","journal-title":"BMC Pregnancy Childbirth"},{"key":"B8","doi-asserted-by":"publisher","first-page":"3633","DOI":"10.1182\/bloodadvances.2020003627","article-title":"Physiologic IGFBP7 levels prolong IGF1R activation in acute lymphoblastic leukemia","volume":"5","author":"Artico","year":"2021","journal-title":"Blood Adv."},{"key":"B9","doi-asserted-by":"publisher","first-page":"12048","DOI":"10.3390\/ijms222112048","article-title":"SUCNR1 is expressed in human placenta and mediates angiogenesis: significance in gestational diabetes","volume":"22","author":"Atallah","year":"2021","journal-title":"Int. J. Mol. Sci."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1185","DOI":"10.1007\/s001250051511","article-title":"Effects of gestational diabetes on junctional adhesion molecules in human term placental vasculature","volume":"43","author":"Babawale","year":"2000","journal-title":"Diabetologia"},{"key":"B11","doi-asserted-by":"publisher","first-page":"T11","DOI":"10.1530\/jme-17-0254","article-title":"IGF-binding proteins","volume":"61","author":"Bach","year":"2018","journal-title":"J. Mol. Endocrinol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.placenta.2020.11.008","article-title":"Decreased maternal serum adiponectin and increased insulin-like growth factor-1 levels along with increased placental glucose transporter-1 expression in gestational diabetes mellitus: possible role in fetal overgrowth","volume":"104","author":"Balachandiran","year":"","journal-title":"Placenta"},{"key":"B13","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1055\/a-1017-3182","article-title":"Placental accumulation of triacylglycerols in gestational diabetes mellitus and its association with altered fetal growth are related to the differential expressions of proteins of lipid metabolism","volume":"129","author":"Balachandiran","year":"","journal-title":"Exp. Clin. Endocrinol. Diabetes"},{"key":"B14","doi-asserted-by":"publisher","first-page":"5269","DOI":"10.3390\/nu14245269","article-title":"Dietary impacts on gestational diabetes: connection between gut microbiome and epigenetic mechanisms","volume":"14","author":"Bankole","year":"2022","journal-title":"Nutrients"},{"key":"B15","doi-asserted-by":"publisher","first-page":"29","DOI":"10.4103\/jmu.Jmu_57_21","article-title":"Correlation of fetal anterior abdominal wall thickness and other standard biometric ultrasound measurements to predict fetal macrosomia in gestational diabetes","volume":"31","author":"Bansal","year":"2023","journal-title":"J. Med. Ultrasound"},{"key":"B16","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1042\/cs0950115","article-title":"In utero programming of chronic disease","volume":"95","author":"Barker","year":"1998","journal-title":"Clin. Sci. (Lond)"},{"key":"B17","doi-asserted-by":"publisher","first-page":"e290","DOI":"10.1542\/peds.2004-1808","article-title":"Metabolic syndrome in childhood: association with birth weight, maternal obesity, and gestational diabetes mellitus","volume":"115","author":"Boney","year":"2005","journal-title":"Pediatrics"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21062120","article-title":"Extracellular vesicles in feto-maternal crosstalk and pregnancy disorders","volume":"21","author":"Buca","year":"2020","journal-title":"Int. J. Mol. Sci."},{"key":"B19","doi-asserted-by":"publisher","first-page":"101606","DOI":"10.1016\/j.ajogmf.2025.101606","article-title":"Systematic review of interventions in early pregnancy among pregnant individuals at risk for hyperglycemia","volume":"7","author":"Calancie","year":"2025","journal-title":"Am. J. Obstet. Gynecol. MFM"},{"key":"B20","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1038\/nsmb.2489","article-title":"Epigenetic programming and reprogramming during development","volume":"20","author":"Cantone","year":"2013","journal-title":"Nat. Struct. Mol. Biol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"3533","DOI":"10.2147\/dmso.S316878","article-title":"The impact of the one-day clinic diabetes mellitus management model on perinatal outcomes in patients with gestational diabetes mellitus","volume":"14","author":"Cao","year":"2021","journal-title":"Diabetes Metab. Syndr. Obes."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1673","DOI":"10.2337\/db18-0123","article-title":"Placental DNA methylation adaptation to maternal glycemic response in pregnancy","volume":"67","author":"Cardenas","year":"2018","journal-title":"Diabetes"},{"key":"B23","doi-asserted-by":"publisher","first-page":"E1037","DOI":"10.1152\/ajpendo.00196.2019","article-title":"No evidence of attenuation of placental insulin-stimulated Akt phosphorylation and amino acid transport in maternal obesity and gestational diabetes mellitus","volume":"317","author":"Castillo-Castrejon","year":"2019","journal-title":"Am. J. Physiol. Endocrinol. Metab."},{"key":"B24","doi-asserted-by":"publisher","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":"B25","doi-asserted-by":"publisher","first-page":"1149","DOI":"10.3390\/ijms26031149","article-title":"Early prediction of fetal macrosomia through maternal lipid profiles","volume":"26","author":"Chagovets","year":"2025","journal-title":"Int. J. Mol. Sci."},{"key":"B26","doi-asserted-by":"publisher","first-page":"165373","DOI":"10.1016\/j.bbadis.2018.12.024","article-title":"Complex, coordinated and highly regulated changes in placental signaling and nutrient transport capacity in IUGR","volume":"1866","author":"Chassen","year":"2020","journal-title":"Biochim. Biophys. Acta Mol. Basis Dis."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.3389\/fphar.2018.01027","article-title":"Physiology and pathophysiology of steroid biosynthesis, transport and metabolism in the human placenta","volume":"9","author":"Chatuphonprasert","year":"2018","journal-title":"Front. Pharmacol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"12650","DOI":"10.1038\/srep12650","article-title":"PPAR\u03b3 stimulates expression of L-type amino acid and taurine transporters in human placentas: the evidence of PPAR\u03b3 regulating fetal growth","volume":"5","author":"Chen","year":"2015","journal-title":"Sci. Rep."},{"key":"B29","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1186\/s12884-020-03157-7","article-title":"The combination of symphysis-fundal height and abdominal circumference as a novel predictor of macrosomia in GDM and normal pregnancy","volume":"20","author":"Chen","year":"2020","journal-title":"BMC Pregnancy Childbirth"},{"key":"B30","doi-asserted-by":"publisher","first-page":"217","DOI":"10.3390\/cells11020217","article-title":"The multiple faces of the GH\/IGF axis","volume":"11","author":"Chesnokova","year":"2022","journal-title":"Cells"},{"key":"B31","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/j.mam.2017.12.002","article-title":"Foetoplacental communication via extracellular vesicles in normal pregnancy and preeclampsia","volume":"60","author":"Chiarello","year":"2018","journal-title":"Mol. Asp. Med."},{"key":"B32","doi-asserted-by":"publisher","first-page":"2528","DOI":"10.2337\/db13-0671","article-title":"PGC1\u03b1 promoter methylation in blood at 5-7 years predicts adiposity from 9 to 14 years (EarlyBird 50)","volume":"63","author":"Clarke-Harris","year":"2014","journal-title":"Diabetes"},{"key":"B33","doi-asserted-by":"publisher","first-page":"e220105","DOI":"10.1530\/jme-22-0105","article-title":"The epidermal growth factor receptor in healthy pregnancy and preeclampsia","volume":"70","author":"Clemente","year":"2023","journal-title":"J. Mol. Endocrinol."},{"key":"B34","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1038\/s41421-025-00821-0","article-title":"Intrauterine hyperglycemia impairs mouse primordial germ cell development and fertility by sex-specific epigenetic reprogramming interference","volume":"11","author":"Cong","year":"2025","journal-title":"Cell Discov."},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.3390\/nu12020506","article-title":"Gestational diabetes mellitus treatment schemes modify maternal plasma cholesterol levels dependent to women\u2019s weight: possible impact on feto-placental vascular function","volume":"12","author":"Contreras-Duarte","year":"2020","journal-title":"Nutrients"},{"key":"B36","doi-asserted-by":"publisher","first-page":"720.e1","DOI":"10.1016\/j.ajog.2015.12.038","article-title":"Safety and pharmacokinetics of pravastatin used for the prevention of preeclampsia in high-risk pregnant women: a pilot randomized controlled trial","volume":"214","author":"Costantine","year":"2016","journal-title":"Am. J. Obstet. Gynecol."},{"key":"B37","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1186\/s13148-016-0239-9","article-title":"PPARGC1\u03b1 gene DNA methylation variations in human placenta mediate the link between maternal hyperglycemia and leptin levels in newborns","volume":"8","author":"C\u00f4t\u00e9","year":"2016","journal-title":"Clin. Epigenetics"},{"key":"B38","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1159\/000099149","article-title":"Midtrimester amniotic fluid leptin and insulin levels and subsequent gestational diabetes","volume":"64","author":"D\u2019Anna","year":"2007","journal-title":"Gynecol. Obstet. Invest"},{"key":"B39","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1007\/s00335-009-9189-2","article-title":"Placental overgrowth and fertility defects in mice with a hypermorphic allele of epidermal growth factor receptor","volume":"20","author":"Dackor","year":"2009","journal-title":"Mamm. Genome"},{"key":"B40","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.bpobgyn.2014.05.012","article-title":"The feto-placental dialogue and diabesity","volume":"29","author":"Desoye","year":"2015","journal-title":"Best. Pract. Res. Clin. Obstet. Gynaecol."},{"key":"B41","doi-asserted-by":"publisher","first-page":"234","DOI":"10.3390\/ijms23010234","article-title":"The insulin-like growth factor signalling pathway in cardiac development and regeneration","volume":"23","author":"D\u00edaz Del Moral","year":"2021","journal-title":"Int. J. Mol. Sci."},{"key":"B42","doi-asserted-by":"publisher","first-page":"1133","DOI":"10.2337\/db11-1314","article-title":"Transgenerational glucose intolerance with Igf2\/H19 epigenetic alterations in mouse islet induced by intrauterine hyperglycemia","volume":"61","author":"Ding","year":"2012","journal-title":"Diabetes"},{"key":"B43","doi-asserted-by":"publisher","first-page":"9752","DOI":"10.21037\/apm-21-2061","article-title":"Systematic review and meta-analysis of the correlation between intestinal flora and gestational diabetes mellitus","volume":"10","author":"Ding","year":"2021","journal-title":"Ann. Palliat. Med."},{"key":"B44","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1186\/s12967-024-04922-4","article-title":"Advances in free fatty acid profiles in gestational diabetes mellitus","volume":"22","author":"Du","year":"2024","journal-title":"J. Transl. Med."},{"key":"B45","doi-asserted-by":"publisher","first-page":"20220561","DOI":"10.1515\/biol-2022-0561","article-title":"High glucose and high lipid induced mitochondrial dysfunction in JEG-3 cells through oxidative stress","volume":"18","author":"Duan","year":"2023","journal-title":"Open Life Sci."},{"key":"B46","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1095\/biolreprod.112.105619","article-title":"Modulation of cholesterol transport by insulin-treated gestational diabetes mellitus in human full-term placenta","volume":"88","author":"Dub\u00e9","year":"2013","journal-title":"Biol. Reprod."},{"key":"B47","doi-asserted-by":"publisher","first-page":"102080","DOI":"10.1016\/j.plefa.2020.102080","article-title":"Maternal dietary fatty acids and their roles in human placental development","volume":"155","author":"Duttaroy","year":"2020","journal-title":"Prostagl. Leukot. Essent. Fat. Acids"},{"key":"B48","doi-asserted-by":"publisher","first-page":"787848","DOI":"10.3389\/fphys.2021.787848","article-title":"Maternal fatty acid metabolism in pregnancy and its consequences in the feto-placental development","volume":"12","author":"Duttaroy","year":"2021","journal-title":"Front. Physiol."},{"key":"B49","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1097\/nmc.0000000000000372","article-title":"The maternal gut microbiome during pregnancy","volume":"42","author":"Edwards","year":"2017","journal-title":"MCN Am. J. Matern. Child. Nurs."},{"key":"B50","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1007\/s00404-017-4433-6","article-title":"Measurement and evaluation of fetal fat layer in the prediction of fetal macrosomia in pregnancies complicated by gestational diabetes","volume":"296","author":"Elessawy","year":"2017","journal-title":"Arch. Gynecol. Obstet."},{"key":"B51","doi-asserted-by":"publisher","first-page":"2468","DOI":"10.2337\/dc10-1190","article-title":"Prothrombotic state, cardiovascular, and metabolic syndrome risk factors in prepubertal children born large for gestational age","volume":"33","author":"Evagelidou","year":"2010","journal-title":"Diabetes Care"},{"key":"B52","doi-asserted-by":"publisher","first-page":"1789","DOI":"10.1007\/s00125-019-4951-9","article-title":"Intrauterine programming of obesity and type 2 diabetes","volume":"62","author":"Fernandez-Twinn","year":"2019","journal-title":"Diabetologia"},{"key":"B53","doi-asserted-by":"publisher","first-page":"1301","DOI":"10.3390\/jpm11121301","article-title":"STRA6 and placental retinoid metabolism in gestational diabetes mellitus","volume":"11","author":"Fruscalzo","year":"2021","journal-title":"J. Pers. Med."},{"key":"B54","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1210\/jcem.84.2.5438","article-title":"Diabetes alters the expression and activity of the human placental GLUT1 glucose transporter","volume":"84","author":"Gaither","year":"1999","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"B55","doi-asserted-by":"publisher","first-page":"2457","DOI":"10.2337\/db10-1434","article-title":"Dysregulation of placental endothelial lipase in obese women with gestational diabetes mellitus","volume":"60","author":"Gauster","year":"2011","journal-title":"Diabetes"},{"key":"B56","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1016\/b978-0-12-387042-1.00007-1","article-title":"Triglyceride metabolism in pregnancy","volume":"55","author":"Ghio","year":"2011","journal-title":"Adv. Clin. Chem."},{"key":"B57","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1007\/s43032-021-00687-z","article-title":"LncRNA-SNX17 promotes HTR-8\/SVneo proliferation and invasion through miR-517a\/IGF-1 in the placenta of diabetic macrosomia","volume":"29","author":"Guiyu","year":"2022","journal-title":"Reprod. Sci."},{"key":"B58","doi-asserted-by":"publisher","first-page":"9804708","DOI":"10.1155\/2019\/9804708","article-title":"Comparative efficacy and safety of metformin, glyburide, and insulin in treating gestational diabetes mellitus: a meta-analysis","volume":"2019","author":"Guo","year":"2019","journal-title":"J. Diabetes Res."},{"key":"B59","doi-asserted-by":"publisher","first-page":"1166533","DOI":"10.3389\/fendo.2023.1166533","article-title":"Birth weight and large for gestational age trends in offspring of pregnant women with gestational diabetes mellitus in southern China, 2012-2021","volume":"14","author":"He","year":"2023","journal-title":"Front. Endocrinol. (Lausanne)"},{"key":"B60","doi-asserted-by":"publisher","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":"B61","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1007\/s00018-017-2595-9","article-title":"Current knowledge on exosome biogenesis and release","volume":"75","author":"Hessvik","year":"2018","journal-title":"Cell Mol. Life Sci."},{"key":"B62","doi-asserted-by":"publisher","first-page":"4257","DOI":"10.3390\/nu13124257","article-title":"Human milk oligosaccharides in cord blood are altered in gestational diabetes and stimulate feto-placental angiogenesis in vitro","volume":"13","author":"Hoch","year":"2021","journal-title":"Nutrients"},{"key":"B63","doi-asserted-by":"publisher","first-page":"100830","DOI":"10.1016\/j.eclinm.2021.100830","article-title":"Association of maternal lipid profile and gestational diabetes mellitus: a systematic review and meta-analysis of 292 studies and 97,880 women","volume":"34","author":"Hu","year":"2021","journal-title":"EClinicalMedicine"},{"key":"B64","doi-asserted-by":"publisher","first-page":"1600325","DOI":"10.3389\/fmicb.2025.1600325","article-title":"Gestational diabetes mellitus alters neonatal gut microbiota and increases infection susceptibility","volume":"16","author":"Hu","year":"2025","journal-title":"Front. Microbiol."},{"key":"B65","doi-asserted-by":"publisher","first-page":"2415","DOI":"10.1093\/advances\/nmab070","article-title":"Placental angiogenesis in mammals: a review of the regulatory effects of signaling pathways and functional nutrients","volume":"12","author":"Huang","year":"2021","journal-title":"Adv. Nutr."},{"key":"B66","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/j.placenta.2019.12.003","article-title":"Decreased placental apoptosis and autophagy in pregnancies complicated by gestational diabetes with large-for-gestational age fetuses","volume":"90","author":"Hung","year":"2020","journal-title":"Placenta"},{"key":"B67","doi-asserted-by":"publisher","first-page":"788969","DOI":"10.3389\/fmed.2021.788969","article-title":"Differential changes in Akt and AMPK phosphorylation regulating mTOR activity in the placentas of pregnancies complicated by fetal growth restriction and gestational diabetes mellitus with large-for-gestational age infants","volume":"8","author":"Hung","year":"2021","journal-title":"Front. Med. (Lausanne)"},{"key":"B68","doi-asserted-by":"publisher","first-page":"165359","DOI":"10.1016\/j.bbadis.2018.12.010","article-title":"Human placental glucose transport in fetoplacental growth and metabolism","volume":"1866","author":"Illsley","year":"2020","journal-title":"Biochim. Biophys. Acta Mol. Basis Dis."},{"key":"B69","doi-asserted-by":"publisher","first-page":"1535","DOI":"10.1042\/cs20220484","article-title":"A novel technique using chronic infusion of small extracellular vesicles from gestational diabetes mellitus causes glucose intolerance in pregnant mice","volume":"136","author":"James-Allan","year":"2022","journal-title":"Clin. Sci. (Lond)"},{"key":"B70","doi-asserted-by":"publisher","first-page":"S109","DOI":"10.1016\/j.placenta.2006.01.017","article-title":"Placental transport and metabolism in fetal overgrowth -- a workshop report","volume":"27","author":"Jansson","year":"2006","journal-title":"Placenta"},{"key":"B71","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1210\/jc.2012-2667","article-title":"Activation of placental mTOR signaling and amino acid transporters in obese women giving birth to large babies","volume":"98","author":"Jansson","year":"2013","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"B72","doi-asserted-by":"publisher","first-page":"3448","DOI":"10.1210\/clinem\/dgab562","article-title":"The association of 9 amino acids with cardiovascular events in Finnish men in a 12-Year Follow-up study","volume":"106","author":"Jauhiainen","year":"2021","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"B73","doi-asserted-by":"publisher","first-page":"239","DOI":"10.3389\/fendo.2017.00239","article-title":"Cross talk between adipose tissue and placenta in Obese and gestational diabetes mellitus pregnancies via exosomes","volume":"8","author":"Jayabalan","year":"2017","journal-title":"Front. Endocrinol. (Lausanne)"},{"key":"B74","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1186\/s12933-025-02739-z","article-title":"Extracellular vesicle-associated miR-515-5p from adipose tissue regulates placental metabolism and fetal growth in gestational diabetes mellitus","volume":"24","author":"Jayabalan","year":"2025","journal-title":"Cardiovasc Diabetol."},{"key":"B75","doi-asserted-by":"publisher","first-page":"104271","DOI":"10.1016\/j.ijnurstu.2022.104271","article-title":"Effects of the original gymnastics for pregnant women program on glycaemic control and delivery outcomes in women with gestational diabetes mellitus: a randomized controlled trial","volume":"132","author":"Jin","year":"2022","journal-title":"Int. J. Nurs. Stud."},{"key":"B76","doi-asserted-by":"publisher","DOI":"10.1002\/cbin.12167","article-title":"Vitronectin promotes insulin resistance in trophoblast cells by activating JNK in gestational diabetes mellitus","author":"Ju","year":"2024","journal-title":"Cell Biol. Int"},{"key":"B77","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1159\/000371628","article-title":"Gestational diabetes mellitus and macrosomia: a literature review","volume":"66","author":"Kc","year":"2015","journal-title":"Ann. Nutr. Metab."},{"key":"B78","doi-asserted-by":"publisher","first-page":"2203","DOI":"10.1038\/s41366-020-0574-y","article-title":"Associations between the activity of placental nutrient-sensing pathways and neonatal and postnatal metabolic health: the ECHO healthy start cohort","volume":"44","author":"Keleher","year":"2020","journal-title":"Int. J. Obes. (Lond)"},{"key":"B79","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1007\/978-3-030-12668-1_12","article-title":"The role of inflammation in the development of GDM and the use of markers of inflammation in GDM screening","volume":"1134","author":"Khambule","year":"2019","journal-title":"Adv. Exp. Med. Biol."},{"key":"B80","doi-asserted-by":"publisher","first-page":"e70554","DOI":"10.7759\/cureus.70554","article-title":"Management of endocrinopathies during pregnancy: a systematic review","volume":"16","author":"Kirovakov","year":"2024","journal-title":"Cureus"},{"key":"B81","doi-asserted-by":"publisher","first-page":"608","DOI":"10.1186\/s13287-021-02678-y","article-title":"The angiogenic properties of human amniotic membrane stem cells are enhanced in gestational diabetes and associate with fetal adiposity","volume":"12","author":"Klid","year":"2021","journal-title":"Stem Cell Res. Ther."},{"key":"B82","doi-asserted-by":"publisher","first-page":"2216","DOI":"10.1002\/oby.20847","article-title":"Effect of extracellular vesicles of human adipose tissue on insulin signaling in liver and muscle cells","volume":"22","author":"Kranendonk","year":"2014","journal-title":"Obesity (Silver Spring)"},{"key":"B83","doi-asserted-by":"publisher","first-page":"7984","DOI":"10.1002\/jcp.30470","article-title":"Novel insights for the role of nitric oxide in placental vascular function during and beyond pregnancy","volume":"236","author":"Krause","year":"2021","journal-title":"J. Cell Physiol."},{"key":"B84","doi-asserted-by":"publisher","first-page":"12286","DOI":"10.3390\/ijms232012286","article-title":"Dysregulation of placental lipid hydrolysis by high-fat\/high-cholesterol feeding and gestational diabetes mellitus in mice","volume":"23","author":"Kuentzel","year":"2022","journal-title":"Int. J. Mol. Sci."},{"key":"B85","doi-asserted-by":"publisher","first-page":"2706","DOI":"10.2337\/dc12-2445","article-title":"Maternal lipids are as important as glucose for fetal growth: findings from the Pune maternal nutrition study","volume":"36","author":"Kulkarni","year":"2013","journal-title":"Diabetes Care"},{"key":"B86","doi-asserted-by":"publisher","first-page":"1893","DOI":"10.1038\/s41467-019-09671-3","article-title":"Meta-analysis of epigenome-wide association studies in neonates reveals widespread differential DNA methylation associated with birthweight","volume":"10","author":"K\u00fcpers","year":"2019","journal-title":"Nat. Commun."},{"key":"B87","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1038\/jp.2014.144","article-title":"Insulin-like growth factor-binding protein 1 and 7 concentrations are lower in obese pregnant women, women with gestational diabetes and their fetuses","volume":"35","author":"Lappas","year":"2015","journal-title":"J. Perinatology"},{"key":"B88","doi-asserted-by":"publisher","first-page":"2933","DOI":"10.1172\/jci86957","article-title":"Pravastatin improves pregnancy outcomes in obstetric antiphospholipid syndrome refractory to antithrombotic therapy","volume":"126","author":"Lefkou","year":"2016","journal-title":"J. Clin. Invest"},{"key":"B89","doi-asserted-by":"publisher","first-page":"122744","DOI":"10.1016\/j.lfs.2024.122744","article-title":"Gut dysbiosis contributes to SCFAs reduction-associated adipose tissue macrophage polarization in gestational diabetes mellitus","volume":"350","author":"Li","year":"2024","journal-title":"Life Sci."},{"key":"B90","doi-asserted-by":"publisher","first-page":"2561847","DOI":"10.1080\/14767058.2025.2561847","article-title":"Gestational diabetes mellitus: modifier or mediator in the link between pre-pregnancy overweight\/obesity and fetal overgrowth?","volume":"38","author":"Li","year":"2025","journal-title":"J. Matern Fetal Neonatal Med."},{"key":"B91","doi-asserted-by":"publisher","first-page":"282","DOI":"10.14310\/horm.2002.1747","article-title":"Maternal serum placental growth hormone, insulin-like growth factors and their binding proteins at 20 weeks\u2019 gestation in pregnancies complicated by gestational diabetes mellitus","volume":"16","author":"Liao","year":"2017","journal-title":"Hormones (Athens)"},{"key":"B92","doi-asserted-by":"publisher","first-page":"86511","DOI":"10.18632\/oncotarget.13442","article-title":"Altered DNA methylation in neonates born large-for-gestational-age is associated with cardiometabolic risk in children","volume":"7","author":"Lin","year":"2016","journal-title":"Oncotarget"},{"key":"B93","doi-asserted-by":"publisher","first-page":"2250","DOI":"10.2337\/db21-0188","article-title":"The choline metabolite TMAO inhibits NETosis and promotes placental development in GDM of humans and mice","volume":"70","author":"Lin","year":"2021","journal-title":"Diabetes"},{"key":"B94","doi-asserted-by":"publisher","first-page":"2581","DOI":"10.2337\/dc11-0728","article-title":"Determinants of body fat in infants of women with gestational diabetes mellitus differ with fetal sex","volume":"34","author":"Lingwood","year":"2011","journal-title":"Diabetes Care"},{"key":"B95","doi-asserted-by":"publisher","first-page":"176","DOI":"10.4103\/ejpi.EJPI-D-24-00111","article-title":"MiR-99 family of exosomes targets myotubularin-related protein 3 to regulate autophagy in trophoblast cells and influence insulin resistance","volume":"68","author":"Liu","year":"2025","journal-title":"J. Physiol. Investig."},{"key":"B96","doi-asserted-by":"publisher","first-page":"1015","DOI":"10.3389\/fphys.2019.01015","article-title":"Alterations of Gut microbiota and blood lipidome in gestational diabetes mellitus with hyperlipidemia","volume":"10","author":"Liu","year":"2019","journal-title":"Front. Physiol."},{"key":"B97","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1186\/s12916-023-03188-9","article-title":"Maternal glycemic status during pregnancy and mid-childhood plasma amino acid profiles: findings from a multi-ethnic Asian birth cohort","volume":"21","author":"Liu","year":"2023","journal-title":"BMC Med."},{"key":"B98","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/j.placenta.2024.04.006","article-title":"Study on the regulation of trophoblast activity by abnormally expressed hsa_circ_0024838\/miR-543\/HIF1A in patients with gestational diabetes mellitus","volume":"151","author":"Liu","year":"2024","journal-title":"Placenta"},{"key":"B99","doi-asserted-by":"publisher","first-page":"101054","DOI":"10.1016\/j.mam.2021.101054","article-title":"Fetoplacental vasculature as a model to study human cardiovascular endocrine disruption","volume":"87","author":"Lorigo","year":"2022","journal-title":"Mol. Aspects Med."},{"key":"B100","doi-asserted-by":"publisher","first-page":"1400","DOI":"10.2174\/1570159x19666211111122311","article-title":"Cholesterol in brain development and perinatal brain injury: more than a building block","volume":"20","author":"Lu","year":"2022","journal-title":"Curr. Neuropharmacol."},{"key":"B101","doi-asserted-by":"publisher","first-page":"1720","DOI":"10.1210\/jc.2011-3296","article-title":"Maternal and fetal IGF-I and IGF-II levels, fetal growth, and gestational diabetes","volume":"97","author":"Luo","year":"2012","journal-title":"J. Clin. Endocrinol. & Metabolism"},{"key":"B102","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1186\/s41043-021-00244-z","article-title":"The second pregnancy has no effect in the incidence of macrosomia: a cross-sectional survey in two Western Chinese regions","volume":"40","author":"Luo","year":"2021","journal-title":"J. Health, Popul. Nutr."},{"key":"B103","doi-asserted-by":"publisher","first-page":"1081","DOI":"10.1007\/s00125-017-4529-3","article-title":"Diabetes and pregnancy: national trends over a 15 year period","volume":"61","author":"Mackin","year":"2018","journal-title":"Diabetologia"},{"key":"B104","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1186\/s12884-025-07250-7","article-title":"Impact of fetal sex on neonatal outcomes in women with gestational diabetes mellitus: a systematic review and meta-analysis","volume":"25","author":"Maghalian","year":"2025","journal-title":"BMC Pregnancy Childbirth"},{"key":"B105","doi-asserted-by":"publisher","first-page":"4607","DOI":"10.1210\/jc.2003-032234","article-title":"Triglyceride hydrolase activities and expression of fatty acid binding proteins in the human placenta in pregnancies complicated by intrauterine growth restriction and diabetes","volume":"89","author":"Magnusson","year":"2004","journal-title":"J. Clin. Endocrinol. & Metabolism"},{"key":"B106","doi-asserted-by":"publisher","first-page":"1728","DOI":"10.1096\/fj.201901424R","article-title":"Exercise improves metabolic function and alters the microbiome in rats with gestational diabetes","volume":"34","author":"Mahizir","year":"2020","journal-title":"Faseb J."},{"key":"B107","doi-asserted-by":"publisher","first-page":"916042","DOI":"10.3389\/fendo.2022.916042","article-title":"Gestational diabetes mellitus and energy-dense diet: what is the role of the Insulin\/IGF axis?","volume":"13","author":"Mart\u00edn-Estal","year":"2022","journal-title":"Front. Endocrinol. (Lausanne)"},{"key":"B108","doi-asserted-by":"publisher","first-page":"1189207","DOI":"10.3389\/fendo.2023.1189207","article-title":"Maternal glucose intolerance during pregnancy affects offspring POMC expression and results in adult metabolic alterations in a sex-dependent manner","volume":"14","author":"Martins","year":"2023","journal-title":"Front. Endocrinol. (Lausanne)"},{"key":"B109","first-page":"455","article-title":"Vascular endothelial growth factor (VEGF) - key factor in normal and pathological angiogenesis","volume":"59","author":"Melincovici","year":"2018","journal-title":"Rom. J. Morphol. Embryol."},{"key":"B110","doi-asserted-by":"publisher","first-page":"703","DOI":"10.1038\/oby.2002.95","article-title":"Age-related changes in fatty acids in obese offspring of streptozotocin-induced diabetic rats","volume":"10","author":"Merzouk","year":"2002","journal-title":"Obes. Res."},{"key":"B111","doi-asserted-by":"publisher","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":"B112","doi-asserted-by":"publisher","first-page":"676","DOI":"10.2337\/dc09-1848","article-title":"International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy","volume":"33","author":"Metzger","year":"2010","journal-title":"Diabetes Care"},{"key":"B113","doi-asserted-by":"publisher","first-page":"424","DOI":"10.3390\/life12030424","article-title":"The maternal-fetal gut microbiota axis: physiological changes, dietary influence, and modulation possibilities","volume":"12","author":"Miko","year":"2022","journal-title":"Life (Basel)"},{"key":"B114","doi-asserted-by":"publisher","first-page":"56","DOI":"10.26502\/fjwhd.2644-288400108","article-title":"Placental fatty acid metabolism and transport in a rat model of gestational diabetes mellitus","volume":"6","author":"Mishra","year":"2023","journal-title":"J. Womens Health Dev."},{"key":"B115","doi-asserted-by":"publisher","first-page":"eAO0583","DOI":"10.31744\/einstein_journal\/2024AO0583","article-title":"Influence of maternal hyperglycemia on placental capillary distribution","volume":"22","author":"Moreli","year":"2024","journal-title":"Einstein (Sao Paulo)"},{"key":"B116","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.earlhumdev.2016.01.008","article-title":"Fetal and maternal metabolic responses to exercise during pregnancy","volume":"94","author":"Mottola","year":"2016","journal-title":"Early Hum. Dev."},{"key":"B117","doi-asserted-by":"publisher","first-page":"1375","DOI":"10.3390\/nu15061375","article-title":"The effects of probiotics\/synbiotics on glucose and lipid metabolism in women with gestational diabetes mellitus: a meta-analysis of randomized controlled trials","volume":"15","author":"Mu","year":"2023","journal-title":"Nutrients"},{"key":"B118","doi-asserted-by":"publisher","DOI":"10.3390\/nu10101507","article-title":"Maternal choline and betaine supplementation modifies the placental response to hyperglycemia in mice and human trophoblasts","volume":"10","author":"Nanobashvili","year":"2018","journal-title":"Nutrients"},{"key":"B119","volume-title":"2018 surveillance of diabetes in pregnancy: management from preconception to the postnatal period (NICE guideline NG3)","year":"2018"},{"key":"B120","doi-asserted-by":"publisher","first-page":"904","DOI":"10.1007\/s43032-021-00755-4","article-title":"Relationships between placental lipid Activated\/transport-related factors and macrosomia in healthy pregnancy","volume":"29","author":"Ni","year":"2022","journal-title":"Reprod. Sci."},{"key":"B121","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1210\/jc.2014-3281","article-title":"Placental growth response to maternal insulin in early pregnancy","volume":"100","author":"O\u2019Tierney-Ginn","year":"2015","journal-title":"J. Clin. Endocrinol. & Metabolism"},{"key":"B122","doi-asserted-by":"publisher","first-page":"9959779","DOI":"10.1155\/2021\/9959779","article-title":"Associations between gestational diabetes and anxiety or depression: a systematic review","volume":"2021","author":"OuYang","year":"2021","journal-title":"J. Diabetes Res."},{"key":"B123","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1038\/s41392-023-01608-z","article-title":"Multifaceted role of mTOR (mammalian target of rapamycin) signaling pathway in human health and disease","volume":"8","author":"Panwar","year":"2023","journal-title":"Signal Transduct. Target Ther."},{"key":"B124","doi-asserted-by":"publisher","first-page":"2941","DOI":"10.3390\/biomedicines13122941","article-title":"Maternal gut microbiota in gestational diabetes mellitus and fetal macrosomia: is there an association?","volume":"13","author":"Pa\u0161i\u0107","year":"2025","journal-title":"Biomedicines"},{"key":"B125","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1016\/j.placenta.2023.07.006","article-title":"Extracellular vesicles-crucial players in human pregnancy","volume":"140","author":"Paul","year":"2023","journal-title":"Placenta"},{"key":"B126","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1530\/acta.0.0160330","article-title":"Weight and length at birth of infants of diabetic mothers","volume":"16","author":"Pedersen","year":"1954","journal-title":"Acta Endocrinol. (Copenh)"},{"key":"B127","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1186\/s12944-025-02458-0","article-title":"Impact of maternal lipid profiles on offspring birth size in late pregnancy among women with and without gestational diabetes","volume":"24","author":"Peng","year":"2025","journal-title":"Lipids Health Dis."},{"key":"B128","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1016\/j.abb.2008.06.015","article-title":"Leptin prevents apoptosis of trophoblastic cells by activation of MAPK pathway","volume":"477","author":"P\u00e9rez-P\u00e9rez","year":"2008","journal-title":"Arch. Biochem. Biophys."},{"key":"B129","doi-asserted-by":"publisher","DOI":"10.3390\/nu11051092","article-title":"Biomarkers of nutrition and health: new tools for new approaches","volume":"11","author":"Pic\u00f3","year":"2019","journal-title":"Nutrients"},{"key":"B130","doi-asserted-by":"publisher","first-page":"770","DOI":"10.1016\/j.placenta.2010.07.003","article-title":"Vascular endothelial growth factor (VEGF) and VEGF-receptor expression in placenta of hyperglycemic pregnant women","volume":"31","author":"Pietro","year":"2010","journal-title":"Placenta"},{"key":"B131","doi-asserted-by":"publisher","first-page":"e875","DOI":"10.1210\/clinem\/dgaa814","article-title":"Placental inositol reduced in gestational diabetes as glucose alters inositol transporters and IMPA1 enzyme expression","volume":"106","author":"Pillai","year":"2021","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"B132","doi-asserted-by":"publisher","first-page":"1691","DOI":"10.1016\/j.ajog.2005.04.015","article-title":"Maternal plasma concentrations of IGF-1, IGFBP-1, and C-peptide in early pregnancy and subsequent risk of gestational diabetes mellitus","volume":"193","author":"Qiu","year":"2005","journal-title":"Am. J. Obstet. Gynecol."},{"key":"B133","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1007\/s00125-023-06066-4","article-title":"Maternal and neonatal outcomes according to the timing of diagnosis of hyperglycaemia in pregnancy: a nationwide cross-sectional study of 695,912 deliveries in France in 2018","volume":"67","author":"Regnault","year":"2024","journal-title":"Diabetologia"},{"key":"B134","doi-asserted-by":"publisher","DOI":"10.3390\/ijms18081729","article-title":"Manipulation of the growth hormone-insulin-like growth factor (GH-IGF) axis: a treatment strategy to reverse the effects of early life developmental programming","volume":"18","author":"Reynolds","year":"2017","journal-title":"Int. J. Mol. Sci."},{"key":"B135","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1515\/jpm-2021-0315","article-title":"Physical exercise in pregnancy: benefits, risks and prescription","volume":"50","author":"Ribeiro","year":"2022","journal-title":"J. Perinat. Med."},{"key":"B136","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1042\/cs20150554","article-title":"Regulation of amino acid transporter trafficking by mTORC1 in primary human trophoblast cells is mediated by the ubiquitin ligase Nedd4-2","volume":"130","author":"Rosario","year":"2016","journal-title":"Clin. Sci. (Lond)"},{"key":"B137","doi-asserted-by":"publisher","first-page":"7273","DOI":"10.3390\/ijms24087273","article-title":"Placental remote control of fetal metabolism: trophoblast mTOR signaling regulates liver IGFBP-1 phosphorylation and IGF-1 bioavailability","volume":"24","author":"Rosario","year":"","journal-title":"Int. J. Mol. Sci."},{"key":"B138","doi-asserted-by":"publisher","first-page":"1651","DOI":"10.1042\/cs20230490","article-title":"Overexpression of the LAT1 in primary human trophoblast cells increases the uptake of essential amino acids and activates mTOR signaling","volume":"137","author":"Rosario","year":"","journal-title":"Clin. Sci. (Lond)"},{"key":"B139","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1186\/s12884-023-05524-6","article-title":"High TXNIP expression accelerates the migration and invasion of the GDM placenta trophoblast","volume":"23","author":"Sa","year":"2023","journal-title":"BMC Pregnancy Childbirth"},{"key":"B140","doi-asserted-by":"publisher","first-page":"1090","DOI":"10.1111\/aogs.12431","article-title":"Epigenetics as the mediator of fetal programming of adult onset disease: what is the evidence?","volume":"93","author":"Saffery","year":"2014","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"B141","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1186\/s13098-019-0471-5","article-title":"Effect of L. acidophilus and B. lactis on blood glucose in women with gestational diabetes mellitus: a randomized placebo-controlled trial","volume":"11","author":"Sahhaf Ebrahimi","year":"2019","journal-title":"Diabetol. Metab. Syndr."},{"key":"B142","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1186\/s13098-020-00603-6","article-title":"Probiotics supplementation and insulin resistance: a systematic review","volume":"12","author":"Salles","year":"2020","journal-title":"Diabetol. Metab. Syndr."},{"key":"B143","doi-asserted-by":"publisher","first-page":"e56594","DOI":"10.1371\/journal.pone.0056594","article-title":"Prenatal metformin exposure in mice programs the metabolic phenotype of the offspring during a high fat diet at adulthood","volume":"8","author":"Salom\u00e4ki","year":"2013","journal-title":"PLoS One"},{"key":"B144","doi-asserted-by":"publisher","first-page":"598","DOI":"10.2337\/db15-0966","article-title":"Gestational diabetes mellitus is associated with changes in the concentration and bioactivity of placenta-derived exosomes in maternal circulation across gestation","volume":"65","author":"Salomon","year":"2015","journal-title":"Diabetes"},{"key":"B145","doi-asserted-by":"publisher","first-page":"9770","DOI":"10.3390\/ijms24119770","article-title":"Human placental adaptive changes in response to maternal obesity: sex specificities","volume":"24","author":"Santos","year":"2023","journal-title":"Int. J. Mol. Sci."},{"key":"B146","doi-asserted-by":"publisher","first-page":"3000605231172895","DOI":"10.1177\/03000605231172895","article-title":"Placental weight and its relationship with the birth weight of term infants and body mass index of the mothers","volume":"2023","author":"Sathasivam","year":"2023","journal-title":"J. Int. Med. Res."},{"key":"B147","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1177\/1933719115602765","article-title":"Expression of mammalian target of Rapamycin and downstream targets in normal and gestational diabetic human term placenta","volume":"23","author":"Sati","year":"2016","journal-title":"Reprod. Sci."},{"key":"B148","doi-asserted-by":"publisher","first-page":"361","DOI":"10.3390\/metabo14070361","article-title":"Association of DNA methylation with infant birth weight in women with gestational diabetes","volume":"14","author":"Saucedo","year":"2024","journal-title":"Metabolites"},{"key":"B149","doi-asserted-by":"publisher","first-page":"E1083","DOI":"10.1210\/jc.2010-2084","article-title":"Fatty acid binding protein 4 regulates intracellular lipid accumulation in human trophoblasts","volume":"96","author":"Scifres","year":"2011","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"B150","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1016\/j.placenta.2017.07.001","article-title":"Maternal BMI and gestational diabetes alter placental lipid transporters and fatty acid composition","volume":"57","author":"Segura","year":"2017","journal-title":"Placenta"},{"key":"B151","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1113\/ep090442","article-title":"Placental adaptations supporting fetal growth during normal and adverse gestational environments","volume":"108","author":"Sferruzzi-Perri","year":"2023","journal-title":"Exp. Physiol."},{"key":"B152","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1111\/aogs.14997","article-title":"Analysis of self-monitoring of blood glucose metrics in gestational diabetes mellitus and their association with infants born large for gestational age: a historical observational cohort study of 879 pregnancies","volume":"104","author":"Shaat","year":"2024","journal-title":"Acta Obstetricia Gynecol. Scand."},{"key":"B153","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1016\/j.diabres.2018.10.017","article-title":"Increased placental IGF-1\/mTOR activity in macrosomia born to women with gestational diabetes","volume":"146","author":"Shang","year":"2018","journal-title":"Diabetes Res. Clin. Pract."},{"key":"B154","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1186\/s12884-023-05630-5","article-title":"Association between second- and third-trimester maternal lipid profiles and adverse perinatal outcomes among women with GDM and non-GDM: a retrospective cohort study","volume":"23","author":"Shi","year":"2023","journal-title":"BMC Pregnancy Childbirth"},{"key":"B155","doi-asserted-by":"publisher","first-page":"e14157","DOI":"10.1111\/apha.14157","article-title":"Regulation of placental amino acid transport in health and disease","volume":"240","author":"Shimada","year":"2024","journal-title":"Acta Physiol. (Oxf)"},{"key":"B156","doi-asserted-by":"publisher","first-page":"834","DOI":"10.2337\/diabetes.48.4.834","article-title":"Effect of insulin on fat metabolism during and after normal pregnancy","volume":"48","author":"Sivan","year":"1999","journal-title":"Diabetes"},{"key":"B157","doi-asserted-by":"publisher","first-page":"e232","DOI":"10.1016\/j.wombi.2017.10.004","article-title":"Combination of a structured aerobic and resistance exercise improves glycaemic control in pregnant women diagnosed with gestational diabetes mellitus. A randomised controlled trial","volume":"31","author":"Sklempe Kokic","year":"2018","journal-title":"Women Birth"},{"key":"B158","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1111\/obr.12391","article-title":"The effect of dietary approaches to stop hypertension (DASH) diet on weight and body composition in adults: a systematic review and meta-analysis of randomized controlled clinical trials","volume":"17","author":"Soltani","year":"2016","journal-title":"Obes. Rev."},{"key":"B159","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.placenta.2021.01.015","article-title":"Dysregulated miRNAs contribute to altered placental glucose metabolism in patients with gestational diabetes via targeting GLUT1 and HK2","volume":"105","author":"Song","year":"2021","journal-title":"Placenta"},{"key":"B160","doi-asserted-by":"publisher","first-page":"1072","DOI":"10.3390\/nu14051072","article-title":"Pre-pregnancy body mass index and risk of macrosomia and large for gestational age births with gestational diabetes mellitus as a mediator: a prospective cohort study in central China","volume":"14","author":"Song","year":"2022","journal-title":"Nutrients"},{"key":"B161","doi-asserted-by":"publisher","first-page":"650","DOI":"10.1080\/14767058.2017.1387897","article-title":"Analysis of correlations between the placental expression of glucose transporters GLUT-1, GLUT-4 and GLUT-9 and selected maternal and fetal parameters in pregnancies complicated by diabetes mellitus","volume":"32","author":"Stanirowski","year":"2019","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"B162","doi-asserted-by":"publisher","first-page":"e0148399","DOI":"10.1371\/journal.pone.0148399","article-title":"Alteration in expression and methylation of IGF2\/H19 in placenta and umbilical cord blood are associated with macrosomia exposed to intrauterine hyperglycemia","volume":"11","author":"Su","year":"2016","journal-title":"PLOS ONE"},{"key":"B163","doi-asserted-by":"publisher","first-page":"165370","DOI":"10.1016\/j.bbadis.2018.12.021","article-title":"Role of insulin, adenosine, and adipokine receptors in the foetoplacental vascular dysfunction in gestational diabetes mellitus","volume":"1866","author":"Subiabre","year":"2020","journal-title":"Biochim. Biophys. Acta Mol. Basis Dis."},{"key":"B164","doi-asserted-by":"publisher","first-page":"968","DOI":"10.1016\/j.bbalip.2018.05.005","article-title":"Gestational diabetes mellitus modulates cholesterol homeostasis in human fetoplacental endothelium","volume":"1863","author":"Sun","year":"2018","journal-title":"Biochim. Biophys. Acta Mol. Cell Biol. Lipids"},{"key":"B165","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1016\/s0140-6736(24)00825-0","article-title":"Epidemiology and management of gestational diabetes","volume":"404","author":"Sweeting","year":"2024","journal-title":"Lancet"},{"key":"B166","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1038\/nrendo.2009.195","article-title":"Nutritional programming of the metabolic syndrome","volume":"5","author":"Symonds","year":"2009","journal-title":"Nat. Rev. Endocrinol."},{"key":"B167","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/j.mehy.2018.10.022","article-title":"Transferred maternal fatty acids stimulate fetal adipogenesis and lead to neonatal and adult obesity","volume":"122","author":"Szabo","year":"2019","journal-title":"Med. Hypotheses"},{"key":"B168","doi-asserted-by":"publisher","first-page":"2203","DOI":"10.4239\/wjd.v15.i11.2203","article-title":"Effect of exercise during pregnancy on offspring development through ameliorating high glucose and hypoxia in gestational diabetes mellitus","volume":"15","author":"Tang","year":"2024","journal-title":"World J. Diabetes"},{"key":"B169","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1186\/s13148-023-01524-7","article-title":"Maternal glycemia in pregnancy is longitudinally associated with blood DNAm variation at the FSD1L gene from birth to 5 years of age","volume":"15","author":"Taschereau","year":"2023","journal-title":"Clin. Epigenetics"},{"key":"B170","doi-asserted-by":"publisher","first-page":"1535750","DOI":"10.1080\/20013078.2018.1535750","article-title":"Minimal information for studies of extracellular vesicles 2018 (MISEV2018): a position statement of the International Society for Extracellular Vesicles and update of the MISEV2014 guidelines","volume":"7","author":"Th\u00e9ry","year":"2018","journal-title":"J. Extracell. Vesicles"},{"key":"B171","doi-asserted-by":"publisher","first-page":"1226","DOI":"10.1016\/j.cell.2016.01.043","article-title":"Communication by extracellular vesicles: where we are and where we need to Go","volume":"164","author":"Tkach","year":"2016","journal-title":"Cell"},{"key":"B172","doi-asserted-by":"publisher","first-page":"e0182509","DOI":"10.1371\/journal.pone.0182509","article-title":"Gestational diabetes mellitus is associated with increased pro-migratory activation of vascular endothelial growth factor receptor 2 and reduced expression of vascular endothelial growth factor receptor 1","volume":"12","author":"Troncoso","year":"2017","journal-title":"PLoS One"},{"key":"B173","doi-asserted-by":"publisher","first-page":"62","DOI":"10.11604\/pamj.2017.26.62.11440","article-title":"Frequency of fetal macrosomia and the associated risk factors in pregnancies without gestational diabetes mellitus","volume":"26","author":"Usta","year":"2017","journal-title":"Pan Afr. Med. J."},{"key":"B174","doi-asserted-by":"publisher","first-page":"1062116","DOI":"10.3389\/fnut.2022.1062116","article-title":"Protein restriction during lactation causes transgenerational metabolic dysfunction in adult rat offspring","volume":"9","author":"Vargas","year":"2022","journal-title":"Front. Nutr."},{"key":"B175","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1016\/j.bjpt.2018.11.012","article-title":"Impact of exercise during pregnancy on gestational weight gain and birth weight: an overview","volume":"23","author":"Vargas-Terrones","year":"2019","journal-title":"Braz J. Phys. Ther."},{"key":"B176","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1016\/bs.pmbts.2016.12.008","article-title":"Regulation of placental amino acid transport and fetal growth","volume":"145","author":"Vaughan","year":"2017","journal-title":"Prog. Mol. Biol. Transl. Sci."},{"key":"B177","doi-asserted-by":"publisher","first-page":"945","DOI":"10.1007\/s40200-023-01232-2","article-title":"Signature precursor and mature microRNAs in cervical ripening during gestational diabetes mellitus lead to pre-term labor and other impediments in future","volume":"22","author":"Vedika","year":"2023","journal-title":"J. Diabetes Metab. Disord."},{"key":"B178","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1007\/s00125-020-05290-6","article-title":"Compromised barrier integrity of human feto-placental vessels from gestational diabetic pregnancies is related to downregulation of occludin expression","volume":"64","author":"Villota","year":"2021","journal-title":"Diabetologia"},{"key":"B179","doi-asserted-by":"publisher","first-page":"E205","DOI":"10.1152\/ajpendo.00032.2013","article-title":"High glucose levels reduce fatty acid oxidation and increase triglyceride accumulation in human placenta","volume":"305","author":"Visiedo","year":"2013","journal-title":"Am. J. Physiol. Endocrinol. Metab."},{"key":"B180","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1186\/s12884-015-0682-1","article-title":"Exercise intervention during pregnancy can be used to manage weight gain and improve pregnancy outcomes in women with gestational diabetes mellitus","volume":"15","author":"Wang","year":"2015","journal-title":"BMC Pregnancy Childbirth"},{"key":"B181","doi-asserted-by":"publisher","first-page":"e000864","DOI":"10.1136\/bmjdrc-2019-000864","article-title":"Fetuin-A and fetal growth in gestational diabetes mellitus","volume":"8","author":"Wang","year":"2020","journal-title":"BMJ Open Diabetes Res. Care"},{"key":"B182","doi-asserted-by":"publisher","first-page":"599281","DOI":"10.3389\/fcell.2020.599281","article-title":"Molecular bases of VEGFR-2-Mediated physiological function and pathological role","volume":"8","author":"Wang","year":"2020","journal-title":"Front. Cell Dev. Biol."},{"key":"B183","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1080\/09513590.2022.2040474","article-title":"Influence of one-day diabetes mellitus clinic management on blood glucose control and prognosis in patients with gestational diabetes mellitus","volume":"38","author":"Wang","year":"2022","journal-title":"Gynecol. Endocrinol."},{"key":"B184","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1096\/fj.14-254219","article-title":"Insulin requires normal expression and signaling of insulin receptor A to reverse gestational diabetes-reduced adenosine transport in human umbilical vein endothelium","volume":"29","author":"Westermeier","year":"2015","journal-title":"Faseb J."},{"key":"B185","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1002\/dmrr.2729","article-title":"Insulin receptor isoforms: an integrated view focused on gestational diabetes mellitus","volume":"32","author":"Westermeier","year":"2016","journal-title":"Diabetes Metab. Res. Rev."},{"key":"B186","doi-asserted-by":"publisher","first-page":"951","DOI":"10.3389\/fphys.2017.00951","article-title":"Transplacental nutrient transport mechanisms of intrauterine growth restriction in rodent models and humans","volume":"8","author":"Winterhager","year":"2017","journal-title":"Front. Physiol."},{"key":"B187","doi-asserted-by":"publisher","first-page":"848","DOI":"10.2337\/diabetes.48.4.848","article-title":"Multiple metabolic defects during late pregnancy in women at high risk for type 2 diabetes","volume":"48","author":"Xiang","year":"1999","journal-title":"Diabetes"},{"key":"B188","doi-asserted-by":"publisher","first-page":"116815","DOI":"10.1016\/j.biopha.2024.116815","article-title":"The crosstalk between cell death and pregnancy related diseases: a narrative review","volume":"176","author":"Xie","year":"2024","journal-title":"Biomed. & Pharmacother."},{"key":"B189","doi-asserted-by":"publisher","first-page":"123207","DOI":"10.1016\/j.lfs.2024.123207","article-title":"Exploring the molecular underpinnings of macrosomia in gestational diabetes mellitus: the role of EGFR signaling and placental syncytiotrophoblast","volume":"359","author":"Xu","year":"2024","journal-title":"Life Sci."},{"key":"B190","doi-asserted-by":"publisher","first-page":"2436086","DOI":"10.1080\/14767058.2024.2436086","article-title":"Validation of the clinical efficacy of one-day outpatient management of patients with gestational diabetes mellitus","volume":"38","author":"Xu","year":"2025","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"B191","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.placenta.2016.01.014","article-title":"Increased expression of fatty acid binding protein 4 in preeclamptic placenta and its relevance to preeclampsia","volume":"39","author":"Yan","year":"2016","journal-title":"Placenta"},{"key":"B192","doi-asserted-by":"publisher","first-page":"1624","DOI":"10.1097\/cm9.0000000000002226","article-title":"Exercise intervention during pregnancy induces DNA methylation alterations in maternal blood and cord blood","volume":"136","author":"Yan","year":"2023","journal-title":"Chin. Med. J. Engl."},{"key":"B193","doi-asserted-by":"publisher","first-page":"1067282","DOI":"10.3389\/fnut.2023.1067282","article-title":"Long-term outcomes and potential mechanisms of offspring exposed to intrauterine hyperglycemia","volume":"10","author":"Yan","year":"2023","journal-title":"Front. Nutr."},{"key":"B194","doi-asserted-by":"publisher","first-page":"405","DOI":"10.5603\/GP.a2021.0129","article-title":"Potential role of biochemical placentation markers - pregnancy associated plasma protein-A and human chorionic gonadotropin for early gestational diabetes screening - a pilot study","volume":"93","author":"Yanachkova","year":"2022","journal-title":"Ginekol. Pol."},{"key":"B195","doi-asserted-by":"publisher","first-page":"1743","DOI":"10.1038\/s41366-020-0610-y","article-title":"Fetal macrosomia in a hispanic\/latinx predominant cohort and altered expressions of genes related to placental lipid transport and metabolism","volume":"44","author":"Yang","year":"2020","journal-title":"Int. J. Obes. (Lond)"},{"key":"B196","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1016\/S1875-5364(21)60051-1","article-title":"HIF-1: structure, biology and natural modulators","volume":"19","author":"Yang","year":"2021","journal-title":"Chin. J. Nat. Med."},{"key":"B197","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.placenta.2023.09.008","article-title":"Exosome enriched leucine-rich alpha-2-glycoprotein-1 and extracellular matrix protein 1 proteins induce abnormal placental angiogenesis in pregnant mice","volume":"143","author":"Yao","year":"2023","journal-title":"Placenta"},{"key":"B198","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1007\/s00431-022-04653-y","article-title":"Infants with macrosomia and infants of diabetic mothers have increased carotid artery intima-media thickness in childhood","volume":"182","author":"Yapicioglu","year":"2023","journal-title":"Eur. J. Pediatr."},{"key":"B199","doi-asserted-by":"publisher","first-page":"108637","DOI":"10.1016\/j.isci.2023.108637","article-title":"Adverse effects of gestational diabetes mellitus on fetal monocytes revealed by single-cell RNA sequencing","volume":"27","author":"Yin","year":"2024","journal-title":"iScience"},{"key":"B200","doi-asserted-by":"publisher","first-page":"864971","DOI":"10.3389\/fendo.2022.864971","article-title":"Exosomal RNA expression profiles and their prediction performance in patients with gestational diabetes mellitus and macrosomia","volume":"13","author":"Yuan","year":"2022","journal-title":"Front. Endocrinol. (Lausanne)"},{"key":"B201","doi-asserted-by":"publisher","first-page":"1498","DOI":"10.3892\/mmr.2020.11225","article-title":"Association between levels of aquaporin 3 in the placenta and adiponectin in the umbilical cord blood with gestational diabetes mellitus and pregnancy outcome","volume":"22","author":"Zhang","year":"2020","journal-title":"Mol. Med. Rep."},{"key":"B202","doi-asserted-by":"publisher","first-page":"234","DOI":"10.21037\/atm-19-4738","article-title":"Hyperglycemia aggravates monocyte-endothelial adhesion in human umbilical vein endothelial cells from women with gestational diabetes mellitus by inducing Cx43 overexpression","volume":"9","author":"Zhang","year":"2021","journal-title":"Ann. Transl. Med."},{"key":"B203","doi-asserted-by":"publisher","first-page":"3457","DOI":"10.3390\/cells11213457","article-title":"Chemerin-induced down-regulation of placenta-derived exosomal miR-140-3p and miR-574-3p promotes umbilical vein endothelial cells proliferation, migration, and tube formation in gestational diabetes mellitus","volume":"11","author":"Zhang","year":"2022","journal-title":"Cells"},{"key":"B204","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1016\/j.placenta.2021.12.022","article-title":"High glucose increases IGF-2\/H19 expression by changing DNA methylation in HTR8\/SVneo trophoblast cells","volume":"118","author":"Zhang","year":"2022","journal-title":"Placenta"},{"key":"B205","doi-asserted-by":"publisher","first-page":"100330","DOI":"10.1016\/j.advnut.2024.100330","article-title":"Effects of dietary approaches and exercise interventions on gestational diabetes mellitus: a systematic review and bayesian network meta-analysis","volume":"15","author":"Zhang","year":"2024","journal-title":"Adv. Nutr."},{"key":"B206","doi-asserted-by":"publisher","first-page":"807","DOI":"10.1038\/s41598-023-49916-2","article-title":"Risk of adverse pregnancy outcomes in pregnant women with gestational diabetes mellitus by age: a multicentric cohort study in Hebei, China","volume":"14","author":"Zhang","year":"2024","journal-title":"Sci. Rep."},{"key":"B207","doi-asserted-by":"publisher","first-page":"e32518","DOI":"10.1016\/j.heliyon.2024.e32518","article-title":"Upregulation of MMPs in placentas of patients with gestational diabetes mellitus: involvement of the PI3K\/Akt pathway","volume":"10","author":"Zhang","year":"2024","journal-title":"Heliyon"},{"key":"B208","doi-asserted-by":"publisher","first-page":"1759","DOI":"10.1080\/01443615.2022.2036969","article-title":"Association of hyperglycaemia with the placenta of GDM-induced macrosomia with normal pre-pregnancy BMI and the proliferation of trophoblast cells","volume":"42","author":"Zheng","year":"2022","journal-title":"J. Obstet. Gynaecol."}],"container-title":["Frontiers in Cell and Developmental Biology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcell.2026.1744305\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T09:30:15Z","timestamp":1771925415000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcell.2026.1744305\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,3]]},"references-count":208,"alternative-id":["10.3389\/fcell.2026.1744305"],"URL":"https:\/\/doi.org\/10.3389\/fcell.2026.1744305","relation":{},"ISSN":["2296-634X"],"issn-type":[{"value":"2296-634X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,3]]},"article-number":"1744305"}}