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The Journal "Obstetrics and Gynecology"Journal HistoryAims and ScopePolicies on Conflict of Interest, Human and Animal Rights, and Informed ConsentEditorial ProcessData sharing statementAdvertising PolicyThe Process for Handling Cases Requiring Corrections, Retractions, and Editorial Expressions of ConcernEditorial BoardEditorial CounsilInformation for ProfessionalsNewsContacts
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Obstetrics and Gynegology2025№6
Obstetric aspects of gestational diabetes...

Obstetric aspects of gestational diabetes mellitus

DOI
https://dx.doi.org/10.18565/aig.2025.96

Khodzhaeva Z.S., Muminova K.T., Avdeeva A.M., Limonova E.M., Yarygina T.A.

1) Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, Moscow, Russia; 2) Lomonosov Moscow State University, Moscow, Russia; 3) Academician V.I. Krasnopolsky Moscow Regional Research Institute of Obstetrics and Gynecology, Moscow, Russia; 4) A.N. Bakulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health, Moscow, Russia

Gestational diabetes mellitus (GDM) is a common complication of pregnancy affecting 84% of women with hyperglycemia.  Its development is associated with insulin resistance that increases by the middle of the second trimester and peaks in the third trimester of pregnancy. Metabolic imprinting is a critical phenomenon in GDM, which occurs when maternal hyperglycemia causes persistent metabolic changes in the fetus. GDM is associated with a high risk of congenital fetal anomalies (especially congenital heart defects), macrosomia and diabetic fetopathy, which require dynamic qualified ultrasound and Doppler examination. The results of the studies, as well as the high incidence of obesity, indicate the need to change the timing of the oral glucose tolerance test from the traditional (24–28 weeks) to earlier period (middle of the second trimester). When choosing hormone therapy for women with gestational diabetes, who are at risk of miscarriage or preterm birth, it is recommended to prefer micronized progesterone. Unlike synthetic progestins such as 17-hydroxyprogesterone caproate, micronized progesterone does not decrease insulin resistance and has additional benefits, namely anti-inflammatory and neuroprotective effects. 
Conclusion: GDM is not only a problem of the gestational period, it significantly increases the risk of long-term metabolic disorders in mother and child. When it is necessary to prescribe progestogens to patients with GDM, micronized progesterone is considered a preferable option, as its effect on the glycemic profile is less severe.

Authors’ contributions: Khodzhaeva Z.S. – writing and final editing of the text of the article; Muminova K.T., Avdeeva A.M., Yarygina T.A. – selecting literature sources and writing the article; Limonova A.M. – selecting literature sources.
Conflicts of interest: Authors declare lack of the possible conflicts of interest.
Funding: This article was prepared with the support of the Russian Science Foundation Grant No. 24-64-00006, 
https://rscf.ru/project/24-64-00006
For citation: Khodzhaeva Z.S., Muminova K.T., Avdeeva A.M., Limonova E.M., Yarygina T.A. 
Obstetric aspects of gestational diabetes mellitus.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (6): 13-19 (in Russian)
https://dx.doi.org/10.18565/aig.2025.96

Keywords

gestational diabetes mellitus (GDM)
insulin resistance
diabetic fetopathy
micronized progesterone
oral glucose tolerance test
metabolic imprinting
placental hormones
Full text (in Russian)

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Received 07.04.2025

Accepted 15.05.2025

About the Authors

Zulfiуa S. Khodzhaeva, Dr. Med. Sci., Professor, Deputy Director for Research of the Institute of Obstetrics, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4, +7(916)407-75-67, zkhodjaeva@mail.ru,
https://orcid.org/0000-0001-8159-3714
Kamilla T. Muminova, PhD, Researcher at the 1st Department of Pregnancy Pathology, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4, +7(916)373-77-07, kamika91@mail.ru,
https://orcid.org/0000-0003-2708-4366
Anna M. Avdeeva, student, Faculty of Fundamental Medicine, Moscow Scientific and Educational Institute, Lomonosov Moscow State University, 119991, Russia, Moscow, Leninskiye Gory, 1, +7(916)900-06-50, a_avdeeva@oparina4.ru, https://orcid.org/0009-0000-2225-2469
Elizaveta M. Limonova, PhD student at the 1st Department of Pregnancy Pathology, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparin str., 4, +7(922)906-08-07, limoninskay@gmail.com, https://orcid.org/0009-0007-8960-4829
Tamara A. Yarygina, PhD, Head of the Ultrasound Diagnostics Department, Academician V.I. Krasnopolsky Moscow Regional Research Institute of Obstetrics and Gynecology, 101000, Russia, Moscow, Pokrovka str., 22a; Researcher at the Perinatal Cardiology Center, A.N. Bakulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of Russia, 121552, Russia, Moscow, Roublevskoe shosse, 135, +7(903)004-81-22, tamarayarygina@gmail.com, https://orcid.org/0000-0001-6140-1930
Corresponding author: Zulfiya S. Khodzhaeva, zkhodjaeva@mail.ru

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