Significance of altered neutrophil extracellular traps formation during the development of pregnancy complications among patients with gestational diabetes mellitus

Introduction. The interest in neutrophil extracellular traps (NETs) in various conditions, including pregnancy complications was increased over the last decade. Accompanied by gestational diabetes mellitus (GDM) hyperglycemia contributes to neutrophil’s activation and the formation of NETs. The aim of study. In this study, we assess NETosis and placental function parameters of women who received diet only or insulin for treatment of gestational diabetes (GDMD/GDMI). Methods. PR3 circulating levels, associated with NETs formation and placental expression were analyzed by ELISA and immunohistochemistry respectively in GDMD (n=35), GDMI (n=30) and healthy pregnant women (n=30). Clinical data, placental alpha microglobulin-1 (PAMG), placental lactogen and trophoblast glycoprotein (TGB) immunohistochemistry expression were characterized in 30 placentas of GDMD, 20 – GDMI and 25 uncomplicated pregnancies. Results. PR3 placental expression was increased in complicated pregnancies (GDMD – 60,94 vs 31,88, p < 0,001, GDMI – 64,42 vs 31,88, р = 0,009) with no statistical differences between GDMD and GDMI. Though placental protein expression indicated potential ischemia among GDMI patients, newborn’s condition was the same like healthy mother’s group. Placental protein expression and clinical data between GDMD and uncomplicated pregnancy women were similar. Conclusion. The study proposes that NETosis in GDM patients in adequate therapy condition, perhaps don’t stimulate pregnancy complications, in contrast – presents consequences of preexisting placental damage.