Predicting Placental Disorders in Gestational Diabetes Mellitus

Aim. To conduct a critical analysis of published data on structural changes in the placenta associated with gestational diabetes mellitus (GDM) and the possibilities for their prediction. Key points. GDM is one of the most common pregnancy complications, affecting about 14% of women. The article examines the current understanding of the effect of GDM on the “mother — placenta — fetus” system, including metabolic, inflammatory, and vascular changes. The dual nature of hyperglycemia is discussed, both as a potential compensatory mechanism that provides the fetus with energy and as a risk factor for the development of metabolic disorders in the child. Special attention is paid to inflammatory processes in the placenta, oxidative stress, and an imbalance of angiogenic factors, which may contribute to impaired fetoplacental blood flow and cause long-term adverse health consequences for mother and child. Approaches to predicting placental disorders in GDM based on biochemical markers, ultrasound methods, and machine learning algorithms are reviewed. Conclusion. Structural disorders of the placenta in GDM result from complex pathophysiological processes and require further investigation to develop effective methods of prediction, diagnosis, prevention, and treatment aimed at reducing obstetric and perinatal complications.