Offspring exposed to gestational diabetes mellitus (GDM) exhibit greater adiposity at birth. This early-life phenotype may increase offspring risk of developing obesity, metabolic syndrome, type 2 diabetes, and cardiovascular disease later in life. Infants born to women with GDM have a dysregulation of several hormones, cytokines, and growth factors related to fetal fat mass growth. One of the molecular mechanisms of GDM influencing these factors is epigenetic alterations, such as DNA methylation (DNAm). This review will examine the role of DNAm as a potential biomarker for monitoring fetal growth during pregnancy in women with GDM. This information is relevant since it may provide useful new biomarkers for the diagnosis, prognosis, and treatment of fetal growth and its later-life health consequences.

Background: The COVID-19 pandemic has disrupted maternal and postnatal care globally, particularly in low- and middle-income countries. This study investigated sociodemographic, geographic, psychosocial, and obstetric factors associated with inadequate postnatal care utilization in Mexico City during the pandemic.Methods: We conducted a cross-sectional survey among 719 postpartum women at a major obstetric hospital in Mexico City. Maternal sociodemographic data, social support (MOS survey), prenatal care quality (Kessner Index), postnatal depression (Edinburgh Scale), care satisfaction (SERVQUAL), and obstetric history were assessed. Spatial regression models evaluated associations between maternal factors, socioeconomic status (AMAI Index), and postnatal visits, incorporating geographic dependencies.Results: Significant spatial autocorrelation in postnatal visit frequency was observed (χ² = 14.07; p < 0.001) indicating geographic dependencies in healthcare utilization. Higher consultation rates were associated with being a non-qualified worker (β = 0.252), living with a domestic partner (β = 0.196), and belonging to the medium-low socioeconomic group (β = 0.297). Maternal education showed no significant association. The spatial error term confirmed significant geographic dependencies (β = −0.153, p < 0.001).Conclusions: Geographic location, occupation, and socioeconomic status significantly influence postnatal visit frequency during public health crises, while education plays a lesser role. These findings suggest the need for targeted interventions addressing geographic barriers and incorporating mental health support to enhance maternal healthcare access among vulnerable populations. Future research should focus on developing integrated care frameworks that can better withstand disruptions during public health emergencies.

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.