Effects of Maternal Obesity and Gestational Diabetes Mellitus on the Placenta: Current Knowledge and Targets for Therapeutic Interventions

Curr Vasc Pharmacol. 2021;19(2):176-192. doi: 10.2174/1570161118666200616144512.


Obesity and gestational diabetes mellitus (GDM) are becoming more common among pregnant women worldwide and are individually associated with a number of placenta-mediated obstetric complications, including preeclampsia, macrosomia, intrauterine growth restriction and stillbirth. The placenta serves several functions throughout pregnancy and is the main exchange site for the transfer of nutrients and gas from mother to fetus. In pregnancies complicated by maternal obesity or GDM, the placenta is exposed to environmental changes, such as increased inflammation and oxidative stress, dyslipidemia, and altered hormone levels. These changes can affect placental development and function and lead to abnormal fetal growth and development as well as metabolic and cardiovascular abnormalities in the offspring. This review aims to summarize current knowledge on the effects of obesity and GDM on placental development and function. Understanding these processes is key in developing therapeutic interventions with the goal of mitigating these effects and preventing future cardiovascular and metabolic pathology in subsequent generations.

Keywords: Placenta; gestational diabetes mellitus; metabolism; obesity; transport; vascular development.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Blood Glucose / metabolism*
  • Diabetes, Gestational / diagnosis
  • Diabetes, Gestational / metabolism*
  • Diabetes, Gestational / physiopathology
  • Diabetes, Gestational / therapy
  • Energy Metabolism*
  • Female
  • Fetal Development
  • Humans
  • Inflammation Mediators / metabolism
  • Obesity, Maternal / diagnosis
  • Obesity, Maternal / metabolism*
  • Obesity, Maternal / physiopathology
  • Obesity, Maternal / therapy
  • Oxidative Stress
  • Placenta / metabolism*
  • Placenta / pathology
  • Placenta / physiopathology
  • Placentation*
  • Pregnancy
  • Prenatal Exposure Delayed Effects
  • Prognosis


  • Blood Glucose
  • Inflammation Mediators