SUMMARY OBJECTIVE: There is an increase in the prevalence of pre-gestational diabetes in the past decades, mainly due to the increase in the prevalence of obesity in the general population and consequently type 2 diabetes among women of reproductive age. METHODS: This study purposed to describe the delivery characteristics, pregnancy complications, and outcomes among women in Serbia with the pre-gestational type 2 diabetes in the past decade, as well as their pregnancy complications, deliveries, and neonatal outcomes. The study included data from all the pregnant women with pre-gestational type 2 diabetes in Belgrade, Serbia during the period between 2010 and 2020. The final sample consisted of 138 patients. RESULTS: More than half, i.e., 70 (50.7%) had a vaginal delivery, while 48 (34.8%) had elective and 20 (14.5%) had emergency caesarean sections. Throughout the period, there was 1 patient with preeclampsia (0.7%), 5 with pregnancy-induced hypertension (3.6%), 7 had newborns with small for gestational age (5.1%), 28 with macrosomia (20.3%), 12 (8.7%) had preterm births, and one-fifth, i.e., 28 (20.3%) of the newborns had Apgar score under 8. CONCLUSION: The present study revealed that women with type 2 diabetes in pregnancy have a significant burden of pregnancy complications, related to pregnancy, delivery, and newborns. OBJECTIVE pregestational pre decades METHODS characteristics complications decade deliveries Belgrade 201 2020 13 patients RESULTS half ie i e i.e. 50.7% 507 50 (50.7% 4 34.8% 348 34 8 (34.8% 14.5% 145 14 (14.5% sections 0.7%, 07 0.7% , 0 (0.7%) pregnancyinduced induced 3.6%, 36 3.6% 3 6 (3.6%) 5.1%, 51 5.1% (5.1%) 20.3%, 203 20.3% 8.7% 87 (8.7% births onefifth, onefifth one fifth, fifth one-fifth (20.3% CONCLUSION 202 i.e 50.7 (50.7 34.8 (34.8 14.5 (14.5 0.7 (0.7% 3.6 (3.6% 5.1 (5.1% 20.3 8.7 (8.7 (20.3 50. (50. 34. (34. 14. (14. 0. (0.7 3. (3.6 5. (5.1 20. (8. (20. (50 (34 (14 (0. (3. (5. (8 (20 (5 (3 (1 (0 ( (2

Abstract Programmed Cell Death-1 (PCD-1) is a key immune checkpoint receptor, which mainly expresses on activated T, B, Dendritic (DC), Natural Killer (NK), and Treg cells. On the surface of activated T-cells, PCD-1 expression is upregulated after the recognition of peripherals antigens by T cells; subsequently, the elevated binding of PD-1 to Programmed Death Ligand-1 (PD-L1) and Programmed Death Ligand-2 (PD-L2) becomes a key step for downstream inhibitory signaling. Although the role of PD-L1 has been evaluated more thoroughly by clinical research, and PD-L1 has also been used more widely in the clinical setting, PD-L2 also plays an important role in the negative regulation of T-cells, one of the necessary conditions that lead to immune tolerance. Expression of PD-L1 either in tumors or in infiltrating immune cells has been verified predominantly by Immunohistochemistry (IHC) in a variety of tumors, suggesting a role for the PD-1/PD-L1 axis as a prognostic trait and therapeutic target across multiple histotypes. The complex interplay between these factors plays a major role in the diffusion and clinical application of PD-L1 IHC assays as predictive biomarkers of response to PD-1/PD-L1 inhibitors. Checkpoint blockades are registered for the treatment of various cancers, including gynecological malignancies. Death1 1 Death- PCD1 PCD (PCD-1 receptor B DC, DC , (DC) NK, NK (NK) Tcells, Tcells cells, T-cells PCD- subsequently PD1 PD PD- Ligand1 Ligand Ligand- PDL1 PDL L1 L (PD-L1 Ligand2 2 PDL2 L2 (PD-L2 signaling PD-L research setting tolerance (IHC PD1/PDL1 PD1PDL1 PDPDL 1/PD PD-1/PD-L histotypes inhibitors cancers malignancies (PCD- (DC (NK (PD-L PD1/PDL PD1PDL 1PD (PCD