Transgenerational Transmission of GDM and
Epigenetics
In GDM, the abnormal metabolic intrauterine environment affects the development of the fetus by inducing changes in gene expression by epigenetic mechanisms of susceptible cells, leading to the development of diabetes in adulthood. Offspring (F1 generation) of severely and mildly hyperglycemic mothers develops GDM and other metabolic disorders in later life, affecting the second generation (F2 generation) as well. Thus, GDM gives rise to a vicious cycle in which mothers with GDM have babies with epigenetic changes who are prone to develop metabolic disease
later in life, which will give rise to a new generation of mothers with GDM. This trend of passing a disease from one generation to another through epigenetic changes is known as transgenerational transmission ( fig. 2 ).