Elevated placental inflammation as a mediator of adverse outcomes in gestational diabetes mellitus.

Abstract

Gestational diabetes mellitus (GDM) is a prevalent pregnancy complication associated with adverse maternal and neonatal outcomes. This study aims to investigate the expression of key inflammatory markers - tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10), interleukin-6 (IL-6), and nuclear-factor kappa-light chain of B (NFκB) in the placental tissue of GDM and non-GDM women. Additionally, the study explores associations between these markers and neonatal characteristics, placental dimensions, and resolvins levels. This cross-sectional study included 416 singleton pregnant women, comprising 209 with GDM and 207 non-GDM. Placental protein and mRNA expression levels of TNF-α, IL-10, IL-6, and NFκB were measured using ELISA and RT-qPCR. Associations between resolvins and inflammatory markers were also assessed. Placental protein levels of TNF-α, IL-10, and NFκB, as well as gene expression levels of IL-6, were elevated in the GDM group. Furthermore, TNF-α was negatively associated with major axis, thickness and center and cord insertion. Inflammatory markers were negatively associated with head circumference at birth. A negative association was found between placental resolvin E1 (RvE1) levels and the inflammatory markers IL-10, NFκB, and TNF-α. The study highlights the association between pro-inflammatory and pro-resolving mediators in the placenta, providing insights into GDM and its adverse outcomes.