The management of reproductive and perinatal care has never been so advanced. However, a high proportion of pregnancies still have adverse outcomes. These can range from hypertensive disorders of pregnancy to preterm or stillbirth.

Gestational diabetes mellitus (GDM) affects between 1 and 14% of pregnant women, depending on the sample and criteria used. Due to overnutrition and underactivity in the developing world, this number is expected to rise. In GDM, there are extensive complications for both mother and offspring. Postnatal complications for the mother include type 2 diabetes, obesity and cardiovascular dysfunction. The offspring of mothers born with GDM have nearly double the risk of being obese and hyperglycaemic, both have been linked to long-term health complications.

Many interventions are in place to reduce the prevalence and severity of GDM. However, there is a need for GDM to be diagnosed earlier during the pregnancy and treated accordingly. DNA methylation is a mechanism by which certain environmental exposures affect gene expression without altering DNA sequence and has been used as a biomarker for diseases including a variety of cancers. In this project, we aim to use longitudinal birth cohorts to investigate the relationship between DNA methylation, GDM and related factors such as body mass index, smoking, maternal age and parity.

We hope that these investigations will improve our understanding of the mechanisms underlying GDM and possibly lead to the development of a tool that uses DNA methylation in pregnant mothers for early detection of GDM. Ultimately, we hope to identify effective strategies for the prevention and management of GDM.