Abstract
Cardiovascular diseases are a significant health problem worldwide. To date, there is a lack of awareness that perinatal factors can predispose to CVD before birth. Gestational diabetes mellitus is an increasingly prevalent disease associated with poor fetal outcomes and CVD in the offspring. Evidence from the last decades suggests that GDM causes endothelial dysfunction and impairs nutrient transfer across the placenta to the fetus. These pathological features are associated with altered vascular and trophoblastic homeostasis in the placenta, predisposing the offspring to vascular injury, altered metabolic condition, and future CVD. This chapter focuses its discussion on the to-date understanding of GDM fetoplacental vascular and nutrient transfer impairment that causes, along with the latest advances, limitations, and questions that remain unresolved in this field.