Skip to main content
SpringerLink
Log in

Maternal Disease Affecting the Placenta: Diabetes Mellitus

  • Chapter
  • First Online:
The Placenta

  • 538 Accesses

Abstract

Diabetes in pregnancy occurs when a patient with diabetes becomes pregnant or when a glucose tolerance disorder develops during pregnancy. In the second trimester, under the influence of placentally produced hormones, a pronounced insulin resistance develops. At the same time, placental lactogen stimulates an increase in beta cell capacity in the maternal pancreas with increased insulin production. Placental size and function influence the metabolic conversion. If the mother has latent insulin resistance or an impaired capacity to increase insulin secretion, gestational diabetes develops. Placentas of diabetic women show structural changes in all forms of the disease. Often these placentas are more voluminous and show changes in villous vascularization and maturation. A morphology typical for diabetes has not been described. A relationship to metabolic control and to the timing of the onset of hyperglycemia during pregnancy is suspected, but needs to be confirmed in systematic studies.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) (2011) S3-Leitlinie: Gestationsdiabetes mellitus (GDM), Diagnostik Therapie und Nachsorge. Registernr. 057/008, Stand 31.08.2011

    Google Scholar 

  • Ashfaq M, Janjua MZ, Channa MA (2005) Effect of gestational diabetes and maternal hypertension on gross morphology of placenta. J Ayub Med Coll Abbottabad 17(1):44–47

    PubMed  Google Scholar 

  • AWMF (2014) S3-Leitlinie: Diabetes und Schwangerschaft. Registernr. 057/023, Stand 31.12.2014

    Google Scholar 

  • Bernischke K, Kaufmann P, Baergen RN (2006) Pathology of the placenta, 5. Aufl. Springer, New York

    Google Scholar 

  • Clausen TD, Mathiesen ER, Hansen T et al (2008) High prevalence of type 2 diabetes and pre-diabetes in adult offspring of women with gestational diabetes mellitus or type 1 diabetes: the role of intrauterine hyperglycemia. Diabetes Care 31(2):340–346

    Article  PubMed  Google Scholar 

  • Cvitic S et al (2014) Glucose, insulin, and oxygen interplay in placental hypervascularisation in diabetes mellitus. BioMed Res Int 2014:145846. https://doi.org/10.1155/2014/145846

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Das A, Mantena SR, Kannan A, Evans DB, Bagchi MK, Bagchi I (2009) De novo synthesis of estrogen in pregnant uterus is critical for stromal decidualization and angiogenesis. Proc Natl Acad Sci U S A 106(30):12542–12547

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Daskalakis G, Marinopoulos S, Krielesi V, Papapanagiotou A, Papantoniou N, Mesogitis S et al (2008) Placental pathology in women with gestational diabetes. Acta Obstet Gynecol Scand 87(4):403–407

    Article  PubMed  Google Scholar 

  • Desoye G, van Poppel M (2015) The feto-placental dialogue in diabesity. Best Pract Res Clin Obstet Gynaecol 29(1):15–23

    Article  PubMed  Google Scholar 

  • Fleenor D, Petryk A, Driscoll P, Freemark M (2000) Constitutive expression of placental lactogen in pancreatic beta cells: effects on cell morphology, growth, and gene expression. Pediatr Res 47(1):136–142

    Article  CAS  PubMed  Google Scholar 

  • Freemark M (2006) Regulation of maternal metabolism by pituitary and placental hormones: roles in fetal development and metabolic programming. Horm Res 65(3):41–49

    CAS  PubMed  Google Scholar 

  • Fretts RC, Boyd ME, Usher RH, Usher HA (1992) The changing pattern of fetal death, 1961–1988. Obstet Gynecol 79(1):35–39

    CAS  PubMed  Google Scholar 

  • Gluckman PD, Hanson MA, Cooper C, Thornburg KL (2008a) Effect of in utero and early-life conditions on adult health and disease. N Engl J Med 359(1):61–73

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Gluckman PD, Hanson MA, Beedle AS, Raubenheimer D (2008b) Fetal and neonatal pathways to obesity. Front Horm Res 36:61–72

    Article  PubMed  Google Scholar 

  • Guariguata L, Linnenkamp U, Beagley J et al (2014) Global estimates of the prevalence of hyperglycaemia in pregnancy. Diabetes Res Clin Pract 103(2):176–185

    Article  CAS  PubMed  Google Scholar 

  • Higgins MF, Russell NM, Mooney EE, McAuliffe FM (2012) Clinical and ultrasound features of placental maturation in pre-gestational diabetic pregnancy. Early Hum Dev 88(10):817–821

    Article  PubMed  Google Scholar 

  • Huynh J et al (2015a) A systematic review of placental pathology in maternal diabetes mellitus. Placenta 36(2):101–114

    Article  CAS  PubMed  Google Scholar 

  • Huynh J, Yamada J, Beauharnais C, Wenger JB, Thadhani RI, Wexler D, Roberts DJ, Bentley-Lewis R (2015b) Type 1, type 2 and gestational diabetes mellitus differentially impact placental pathologic characteristics of uteroplacental malperfusion. Placenta 36(10):1161–1166

    Article  PubMed  PubMed Central  Google Scholar 

  • Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study Cooperative Research Group, Metzger BE, Lowe LP et al (2008) Hyperglycemia and adverse pregnancy outcomes. N Engl J Med 358(19):1991–2002

    Article  Google Scholar 

  • Ignell C, Claesson R, Anderberg E et al (2014) Trends in the prevalence of gestational diabetes mellitus in southern Sweden, 2003–2012. Acta Obstet Gynecol Scand 93(4):420–424

    Article  PubMed  Google Scholar 

  • Jirkovská M, Kubínová L, Janácek J, Moravcová M, Krejcí V, Karen P (2002) Topological properties and spatial organization of villous capillaries in normal and diabetic placentas. J Vasc Res 39(3):268–278

    Article  PubMed  Google Scholar 

  • Jirkovská M, Kučera T, Kaláb J, Jadrníček M, Niedobová V, Janáček J et al (2012) The branching pattern of villous capillaries and structural changes of placental terminal villi in type 1 diabetes mellitus. Placenta 33(5):343–351

    Article  PubMed  Google Scholar 

  • Kautzky-Willer A (2005) Endocrine changes in diabetic pregnancy. In: Djelmis J, Ivanisevic M, Desoye G (Hrsg) Diabetology of pregnancy, 1. Aufl. Karger Basel, 18–33

    Google Scholar 

  • Little SE et al (2015) A multi-state analysis of early-term delivery trends and the association with term stillbirth. Obstet Gynecol 126(6):1138–1145

    Article  PubMed  Google Scholar 

  • Madazli R, Tuten A, Calay Z, Uzun H, Uludag S, Ocak V (2008) The incidence of placental abnormalities, maternal and cord plasma malondialdehyde and vascular endothelial growth factor levels in women with gestational diabetes mellitus and nondiabetic controls. Gynecol Obstet Investig 65(4):227–232

    Article  CAS  Google Scholar 

  • Mayhew TM (2002) Enhanced fetoplacental angiogenesis in pre-gestational diabetes mellitus: the extra growth is exclusively longitudinal and not accompanied by microvascular remodelling. Diabetologia 45(10):1434–1439

    Article  CAS  PubMed  Google Scholar 

  • Mayhew TM, Jairam IC (2000) Stereological comparison of 3D spatial relationships involving villi and intervillous pores in human placentas from control and diabetic pregnancies. J Anat 197(Pt 2):263–274

    Article  PubMed  PubMed Central  Google Scholar 

  • Mwanri AW, Kinabo J, Ramaiya K et al (2015) Gestational diabetes mellitus in sub-Saharan Africa: systematic review and metaregression on prevalence and risk factors. Tropical Med Int Health 20(8):983–1002

    Article  Google Scholar 

  • Melchior H, Kurch-Bek D, Mund M (2017) The prevalence of gestational diabetes. Dtsch Arztebl Int 114(24):412–418

    PubMed  PubMed Central  Google Scholar 

  • Newbern D, Freemark M (2011) Placental hormones and the control of maternal metabolism and fetal growth. Curr Opin Endocrinol Diabetes Obes 18(6):409–416

    Article  CAS  PubMed  Google Scholar 

  • Rasmussen KM, Catalano PUM, Yaktine AL (2009) New guidelines for weight gain during pregnancy: what obstetricians/gynecologists should know. Curr Opin Obstet Gynecol 21(6):521–526

    Article  PubMed  PubMed Central  Google Scholar 

  • Rudge MV, Lima CP, Damasceno DC, Sinzato YK, Napoli G, Rudge CV, Gallego FQ, Calderon IM (2011) Histopathological placental lesions in mild gestational hyperglycemic and diabetic women. Diabetol Metab Syndr 3(1):19. https://doi.org/10.1186/1758-5996-3-19

    Article  PubMed  PubMed Central  Google Scholar 

  • Schaefer-Graf UM, Pawliczak J, Passow D et al (2005) Birth weight and parental BMI predict overweight in children from mothers with gestational diabetes. Diabetes Care 28(7):1745–1750

    Article  PubMed  Google Scholar 

  • Smulian JC, Ananth CV, Vintzilios AM, Scorza WE, Knuppel RA (2002) Fetal death in the United States. Influence of high-risk conditions and implications for management. Obstet Gynecol 100(6):1183–1189

    PubMed  Google Scholar 

  • Starikov RS, Inman K, Has P, Iqbal SN, Coviello E, He MD (2017) Correlation of placental pathology and perinatal outcomes with hemoglobin A1c in early pregnancy in gravidas with pregastational diabetes mellitus. Placenta 52:94–99

    Article  CAS  PubMed  Google Scholar 

  • Taricco E, Radaelli T, Nobile Santis MS, de Cetin I (2003) Foetal and placental weights in relation to maternal characteristics in gestational diabetes. Placenta 24(4):343–347

    Article  CAS  PubMed  Google Scholar 

  • Weiss PAM (2002) Diabetes und Schwangerschaft. Springer, Wien

    Book  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Clinic for Obstetrics, University Medical Center Jena, Competence Center for Diabetes and Pregnancy, Jena, Germany

    Tanja Groten

Authors
  1. Tanja Groten
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tanja Groten .

Editor information

Editors and Affiliations

  1. Division of Cell Biology Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria

    Berthold Huppertz

  2. Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Jena, Jena, Germany

    Ekkehard Schleußner

Rights and permissions

Reprints and permissions

Copyright information

© 2023 Springer-Verlag GmbH Germany, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Groten, T. (2023). Maternal Disease Affecting the Placenta: Diabetes Mellitus. In: Huppertz, B., Schleußner, E. (eds) The Placenta. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-66256-4_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-66256-4_16

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-66255-7

  • Online ISBN: 978-3-662-66256-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation