2021
DOI: 10.2337/db20-1111
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Pregnancies in Diabetes and Obesity: The Capacity-Load Model of Placental Adaptation

Abstract: Excess nutritional supply to the growing fetus, resulting from maternal diabetes and obesity, is associated with increased risks of fetal maldevelopment and adverse metabolic conditions in postnatal life. The placenta, interposed between mother and fetus, serves as the gateway between the two circulations and is usually considered to mediate maternal exposures to the fetus through a direct supply line. In this Perspective, however, we argue that the placenta is not an innocent bystander and mounts responses to… Show more

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Cited by 18 publications
(14 citation statements)
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“…The placenta plays a central role in regulating the fetal environment [ 16 ]. It not only controls the exchange of nutrients, gasses, and wastes between the maternal and fetal circulations, but is also an important source of hormones that regulate fetal development.…”
Section: Introductionmentioning
confidence: 99%
“…The placenta plays a central role in regulating the fetal environment [ 16 ]. It not only controls the exchange of nutrients, gasses, and wastes between the maternal and fetal circulations, but is also an important source of hormones that regulate fetal development.…”
Section: Introductionmentioning
confidence: 99%
“…The placenta is the key interface between the mother and fetus, and therefore a likely mediator of the effects of maternal health on the developing fetus. Studies in humans and in animal models have shown that placentas from obese pregnancies display lipotoxicity (Jarvie et al 2010) and inflammation (Pantham et al 2015), and have reduced placental vessel density (Hayes et al 2012), highlighting that the protective capacities of the placenta can be exhausted in diabetic and/or obese pregnancies (Desoye & Wells, 2021).…”
Section: Introductionmentioning
confidence: 99%
“…2015), and have reduced placental vessel density (Hayes et al . 2012), highlighting that the protective capacities of the placenta can be exhausted in diabetic and/or obese pregnancies (Desoye & Wells, 2021).…”
Section: Introductionmentioning
confidence: 99%
“…The transport of lipids across the placenta requires hydrolysis of maternal lipoproteins into fatty acids via the placental (PLP) and the endothelial (EL) lipases. The presence of GDM and obesity has been shown to increase the expression of EL (Desoye & Wells 2021). After hydrolysis the fatty acids are taken up by the placenta via fatty acid transport proteins 1 and 4, plasma membrane fatty acid binding protein and the fatty acid translocase CD36 (Herrera & Desoye 2016).…”
Section: Lipid Handlingmentioning
confidence: 99%