I.I. Evsyukova D.O. Ott Research Institute of Obstetrics, Gynecology, and Reproductology, Mendeleevskaya line, 3, Saint-Petersburg, 199034, Russian Federation E-mail: [email protected]

The review summarizes a number of published reports about the influence of total hormonal and metabolic disturbances on the functioning system mother – placenta – fetus in the organism of the women with obesity and gestational diabetes mellitus. The circadian disruption of maternal melatonin production is demonstrated to cause the asynchronous metabolic process, hyperglycemia hyperinsulinemia, increased insulin resistance, hyperleptinemia, activated oxidative stress, development mitochondrial and endothelium dysfunction. Molecular mechanisms of the damage of placental structure and function changes, affecting on the supply of nutrients, oxygen, and methyl donors and alter the secretion of hormones and other signaling molecules into the fetal circulation, are examined. The results of experimental and clinical investigations testify of placental trophic, metabolic, endocrine and transport functions, which determine the pathophysiological mechanisms of development fetus overweight, hyperinsulinemia, changes of qualitative composition of serum density lipoproteins, high content in free fatty serum acids, insulin-like growth factor (IGF-1), markers of endothelium dysfunction and inflammation. Epigenetic modifications of the fetal genome determine the disorders in the morphological-functional development of brain structures, cardio-vascular, and other infant functional systems in early ontogenesis and programming obesity and risk metabolic alterations during adulthood. Hence, the preconception and perinatal period offer a unique opportunity to modify both short and long term risks for both the woman and her offspring.
pregnancy, obesity, gestational diabetes mellitus, placenta, fetus

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