Journal of Developmental Origins of Health and Disease

Original Article

Reduced apoptosis in term placentas from gestational diabetic pregnancies

L. Belkacemia1a2 c1, S. Kjosa1, D. M. Nelsona3, M. Desaia1a2 and M. G. Rossa1a2

a1 Department of Obstetrics and Gynecology, Perinatal Research Laboratories, David Geffen School of Medicine, University of California, Los Angeles, California, USA

a2 Los Angeles Biomedical Research Institute, Harbor-UCLA, Torrance, California, USA

a3 Department of Obstetrics and Gynecology, Washington University, School of Medicine, St. Louis, Missouri, USA


Gestational diabetic mellitus (GDM) pregnancies have an increased risk of macrosomic infants and large placental mass, though the mechanisms explaining each of these is uncertain. We sought to evaluate the contribution of apoptosis to placental size and the expression of glucose transporters (SLC2A) in GDM pregnancies. Maternal age and pre-pregnancy body weight were documented. Newborn weights were recorded after delivery. Placentas 37–40-week gestation from control patients (no pregnancy complication) (n = 5), or with GDM (n = 5) were weighed immediately after delivery. Villous samples (4 mm diameter) were collected and divided into specimens; one was fixed in 4% paraformaldehyde for immunostaining using terminal deoxynucleotidyl transferase dUTP-mediated nick-end labeling (TUNEL) and activated caspase-3. The other specimen was snap frozen in liquid nitrogen and stored at −80°C for active caspase-3, poly(ADP-ribose) polymerase (PARP), SLC2A1 and SLC2A3 gene expression analysis. Our results showed that maternal age and pre-pregnancy body weight were significantly higher in the GDM group when compared with those from the controls (P < 0.05). The mean neonatal birth weight and placenta weight were significantly higher in the GDM group compared with that from the controls (P < 0.05). The apoptotic index of placentas (0.05 ± 0.01 v. 0.17 ± 0.04, P < 0.04), active caspase-3 polypeptide fragments and PARP protein were significantly decreased in GDM placentas as compared with controls. Further, the level of placental SLC2A1 protein expression was ∼3-fold higher in GDM placentas. Our results suggest that reduced apoptosis in GDM placentas may contribute to increased placental tissue, which together with enhanced SLC2A1 expression, could play a role in fetal macrosomia.

(Received November 03 2012)

(Revised February 12 2013)

(Accepted February 19 2013)

Key words

  • apoptosis;
  • gestational diabetes;
  • macrosomia;
  • placenta


c1 Address for correspondence: Dr Louiza Belkacemi, London Health Sciences Center, 339 Windermere Road, London, Ontario, Canada N6A 5A5. (Email