Both GDM and obesity complications constitute independent risk factors that increase problems during delivery and that are associated with an increase in monocyte count in cord blood and with the expression of several genes like the silent information regulator sirtuin 1 (SIRT1) and uncoupling protein 1 (UCP1) in obese pregnant women [139], while growth/differentiation factor 15 (GDF-15) is increased in GDM [141]. This evidence concerns the gene GDF15 and obesity due to melanocortin 4 receptor deficiency.