Potential mechanisms contributing to gestational diabetes and pre-eclampsia in the obese woman

doi:10.1017/CBO9780511782466.006

5 - Potential mechanisms contributing to gestational diabetes and pre-eclampsia in the obese woman

from Section 2 - Pregnancy outcome

Published online by Cambridge University Press: 05 August 2012

Naveed Sattar and

Dilys J. Freeman

Edited by

Matthew W. Gillman and

Lucilla Poston

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Matthew W. Gillman: Affiliation:
Harvard Medical School
Lucilla Poston: Affiliation:
King's College London

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Summary

Introduction

The previous chapter and prior reviews demonstrate clear associations between maternal obesity and a range of pregnancy complications. Chief among these are gestational diabetes mellitus (GDM) and pre-eclampsia (PE), but other complications are also overrepresented including greater miscarriage risk, more cesarean sections, and even a heightened risk for intrauterine growth restriction (IUGR). The present chapter will discuss potential mechanisms linking obesity to GDM and PE. It will discuss postulated pathways, particularly for the obesity–PE link, and will show that many of these causal inferences are generally unfounded or exaggerated. The chapter will also provide a framework for future studies and describe potential strategies whereby the causal pathways may be explored.

Obesity and GDM

The strong epidemiological association between obesity and type 2 diabetes mellitus (T2DM) is well described [1]. Similarly, as noted in the previous chapter, the same is also true for the obesity–GDM link. However, in recent years our understanding of the mechanisms linking obesity to diabetes in the non-pregnant arena has advanced considerably. A brief description of this highly relevant background is helpful for subsequent considerations of the pathways linking obesity to GDM.

Keywords

bariatric surgery cardiovascular disease gestational diabetes mellitus pre-eclampsia pregnancy obesity lifestyle interventions maternal fat metabolism

Type: Chapter
Information: Maternal Obesity , pp. 45 - 55

DOI: https://doi.org/10.1017/CBO9780511782466.006 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2012

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5 - Potential mechanisms contributing to gestational diabetes and pre-eclampsia in the obese woman

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