Gestational diabetes mellitus (GDM) is the most common metabolic disorder of pregnancy and has considerable short- and long-term consequences for the health of both the mother and the newborn. Within its pathophysiology, genetic, nutritional, epigenetic, immunological, and hormonal components have been described. Within the last two items, it is known that different hormones and cytokines secreted by adipose tissue, known collectively as adipokines, are involved in the metabolic alterations underlying GDM. Although the maternal circulating profile of adipokines in GDM has been extensively studied, and there are excellent reviews on the subject, it is in recent years that more progress has been made in the study of their expression in visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), placenta, and their concentrations in the umbilical circulation. Thus, this review compiles and organizes the most recent findings on the maternal and umbilical circulating profile and the levels of expression of adipokines in VAT, SAT, and placenta in GDM.

Background: Antimicrobial resistance is a global health problem, due to morbidity, mortality, and healthcare costs. The misuse of antimicrobials is the main cause of antimicrobial resistance. The aim of this study was to report antimicrobial resistance and antibiotic consumption in a secondary care hospital in Mexico. Methods: Within a cross-sectional study, antimicrobial resistance data on ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) and antibiotic consumption from 2020 to 2022 were collected. Antimicrobial resistance was reported based on percentages of resistance and consumption was analyzed using the defined daily dose (DDD)/100 bed days and the AWaRe (Access, Surveillance, Reservation) antibiotic group. Results: Antibiotic consumption in 2020, 2021 and 2022 was 330, 175 and 175 DDD/100 beds day, respectively. The rate of ceftriaxone resistance in E. coli (n = 526) and K. pneumoniae (n = 80) was 76% and 69%, respectively, the rate of carbapenem resistance in A. baumannii (n = 168) and P. aeruginosa (n = 108) was 92% and 52%, respectively; the rate of oxacillin resistance in S. aureus (n = 208) was 27%; and the rate of vancomycin resistance in E. faecium (n = 68) was 47%. Conclusion: The reported results are congruent with global estimates of antibiotic resistance and consumption, providing an overview that could generate actions for antimicrobial optimization at the local and regional levels.

Background: Adequate gestational weight gain (GWG) is essential for maternal and fetal health. GWG may be a sign of higher visceral adipose tissue (VAT) accretion. A higher proportion of VAT is associated with an inflammatory process that may play a role in the fetal programming of obesity. This study aimed to (1) compare the expression of genes involved in inflammatory responses (TLR2, TLR4, NFκB, IKKβ, IL-1RA, IL-1β, IL-6, IL-10, TNF-α) in the VAT of pregnant women according to GWG and (2) explore whether VAT inflammation and GWG are related to offspring anthropometric measures. Material and methods: 50 women scheduled for cesarean section who delivered term infants were included in the study. We collected maternal omental VAT, and the expression of genes was examined with RT-qPCR. Results: Women with excessive and with adequate GWG had significantly higher expressions of most inflammatory genes than women with insufficient GWG. Neonates from mothers with excessive GWG had greater birth weight and chest circumference than those from mothers with insufficient GWG. GWG was positively correlated with fetal birth weight. Conclusions: The VAT expression of most genes associated with inflammatory pathways was higher in excessive and adequate GWG than in pregnant women with insufficient GWG. Moreover, GWG was found to be positively associated with newborn weight.

Breastfeeding is recommended as the preferred method of feeding for infants for at least 1 year, because of its multiple immediate and long-term benefits for both the mother and child. Among women with a history of gestational diabetes mellitus (GDM), breastfeeding is associated with increased insulin sensitivity, improved insulin secretion, improved glucose tolerance, and a reduced incidence of type 2 diabetes mellitus (T2DM). Lactation has also been associated with postpartum weight loss, reduced long-term obesity risk, a lower prevalence of the metabolic syndrome, hypertension, and cardiovascular disease. The mechanisms underlying the benefits of breastfeeding for the mother are unclear. However, a role of adipose tissue-produced cytokines (adipokines) has been suggested. Lactation appears to mobilize adipose tissue accrued during pregnancy, and some changes in adipokine levels have been reported. Higher lactation intensity has been associated with lower plasma leptin, a peptide mainly associated with appetite regulation and insulin resistance.

Background/Objectives: Gestational diabetes mellitus (GDM) is characterized by a systemic inflammatory response and the expression of inflammatory factors in visceral adipose tissue (VAT). However, the association between these two inflammatory processes has not been fully elucidated. Therefore, this study aimed to (1) investigate whether whole blood counts, the neutrophil–lymphocyte ratio (NLR), the monocyte–lymphocyte ratio (MLR), serum adiponectin levels, and the mRNA expression of inflammatory genes (TLR2, TLR4, pro-inflammatory cytokines: IL-1β, IL-6, and TNF-α, anti-inflammatory cytokines: IL-1RA, IL-10, and adiponectin) in VAT are altered in women with GDM in comparison to pregnant women with normal glucose tolerance (NGT), and (2) determine the correlations between systemic and local VAT inflammation in all, GDM, and NGT women. Methods: Study of 50 GDM and 50 women with NGT with a cross-sectional design. Standard biochemical and hematological tests were conducted and relative mRNA expression in VAT was measured by RT-qPCR. Results: Women with GDM showed higher neutrophil, monocyte, NLR, MLR, and VAT TNF-α/IL-10 mRNA expression ratios while lymphocyte and eosinophil counts, serum adiponectin, and mRNA local VAT inflammatory markers such as TLR2, TLR4, IL-1β, IL-6, IL-1RA, and IL-10 were lower in women with GDM relative to women with NGT. Additionally, the circulating monocyte count were associated with TLR2 and TLR-4 VAT mRNA expression levels and eosinophils count were associated with IL-1β, IL-6, IL-10, and IL-1RA VAT expression levels in women with GDM. Conclusions: GDM is characterized by systemic inflammation, and some circulating immune cells, such as monocytes and eosinophils, are associated with the expression of inflammatory markers in VAT.

Gestational diabetes mellitus (GDM) increases the risk of fetal overgrowth and macrosomia, yet the molecular mechanisms remain unclear. Emerging evidence implicates primate-specific placental microRNAs (miRNAs) from the C19MC cluster in modulating fetal growth via the insulin-like growth factor (IGF) axis. This study aimed to investigate the expression of circulating C19MC miRNAs in GDM pregnancies and their association with IGF axis biomarkers and birthweight outcomes. In this cross-sectional study, 158 pregnant women were stratified into normoglycemic pregnancies (n = 52), GDM with normal birthweight (n = 56), and GDM with large-for-gestational-age (LGA) newborns (n = 50). Plasma levels of 19 C19MC miRNAs and IGF-related proteins were measured. Associations between miRNAs, IGF axis components, and birthweight were analyzed using linear regression and correlation models adjusted for relevant covariates. Several miRNAs, including miR-516a-5p, miR-518d-3p, miR-521, and miR-525-3p, were differentially expressed in GDM, particularly in LGA cases. Strong correlations were observed, such as that of miR-516a-5p with IGFBP-5 (r = 0.705; p < 0.001). Inverse associations with birthweight were found for miR-519b-3p, miR-518d-5p, and miR-520a-5p. Circulating C19MC miRNAs are dysregulated in GDM and correlate with IGF signaling and fetal growth, supporting their potential as early biomarkers for macrosomia risk in GDM.