Emerging biomarkers for gestational diabetes mellitus and related pediatric outcomes.

Gestational diabetes mellitus (GDM) is a metabolic condition caused by chronic insulin resistance during pregnancy, affecting millions of women globally and causing significant health concerns. Its consequences are far-reaching, associated with poor feto-maternal outcomes. GDM has serious implications on metabolic health in both mother and child. Early diagnosis and management of GDM are crucial to prevent related consequences. Traditional diagnostic and predictive biomarkers for GDM, including oral glucose tolerance test, adiponectin, resistin, etc., have limitations. Recent advances in research have identified novel biomarkers for GDM, offering promising alternatives for early diagnosis and prediction to prevent the associated adverse pediatric outcomes. Emerging biomarkers include microRNAs, cell-free DNA, exosomes, glycolytic intermediates, inflammatory biomarkers (C-reactive protein and interleukin-6), metabolic biomarkers (Betatrophin, fetuin-A, etc.), etc. Emerging bidirectional communication pathway (gut microbiota gut-brain-axis) plays a crucial role in GDM pathophysiology, and could be a promising biomarker. Emerging technologies such as next-generation sequencing, metabolomics, and proteomics have enabled the discovery of novel biomarkers for GDM and related pediatric outcomes. This review aims to summarize the current state of knowledge on emerging biomarkers for GDM, including their diagnostic accuracy, predictive value, and potential clinical applications to improve feto-maternal outcomes by personalized medicine approaches.