“…Maternal insulin resistance and increased body mass index (BMI) during pregnancy are associated with changes in placental levels of multiple major metabolites such as lipids, carbohydrates, acylcarnitines, branched-chain amino acids, folate, and choline which correlate, in part, to fetal size [ 20 , 21 ]. GDM, along with its related obesity, contributes to placental DNA methylation, which can negatively affect the developing fetus [ 1 , 2 , 20 ]. GDM increases the rates of miscarriage, dystocia, cesarean section, neonatal death, premature birth, congenital anomalies, macrosomia, respiratory distress, neonatal jaundice, hypoglycemia, hypocalcemia, and polycythemia [ 18 , 22 , 23 ].…”