Immune dysregulation linking pre-pregnancy obesity to gestational diabetes mellitus

Résumé fourni par la source

Gestational diabetes mellitus (GDM) is a prevalent metabolic complication of pregnancy with rising global incidence. Its increasing prevalence parallels the rising rates of pre-pregnancy obesity worldwide. While physiological insulin resistance is a normal feature of pregnancy, excess maternal adiposity exacerbates this process and significantly increases the risk of GDM. Emerging evidence highlights immune dysregulation as a plausible mechanistic link between pre-pregnancy obesity and impaired metabolic adaptation during pregnancy. Obesity is characterised by chronic, low-grade inflammation, driven by adipose tissue expansion, immune cell infiltration, and dysregulated cytokine and adipokine production. These changes may collectively impair insulin signalling, disrupt placental function, and alter maternal–foetal immune tolerance. In this review, we synthesise current understanding of the immunological pathways connecting pre-pregnancy obesity to GDM, including alterations in innate and adaptive immune responses, soluble inflammatory mediators, and placental immune dynamics. By integrating metabolic and immunological perspectives, this narrative mini-review highlights potential mechanisms underpinning obesity-associated GDM and highlights critical gaps in knowledge relevant to early risk stratification and targeted prevention strategies.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.