Figure 1: Proposed effects of adenosine on the human placenta and fetal central nervous system in GDM The syndrome GDM is characterized by reduced uptake of adenosine via nucleoside membrane transporters leading to increased extracellular adenosine concentration. This phenomenon could results in a higher activation of adenosine receptors in the human placenta and the central nervous system (CNS). Several alterations are associated with this abnormal activation of adenosine receptors, including vascular dysfunction and altered angiogenesis in the fetoplacental vasculature, and modifications in phenomena such as differentiation, migration and synaptogenesis in the CNS. As a consequence of these alterations, GDM ends in an altered fetal development.