Skip to main content
SpringerLink
Log in

Placental histopathological findings in obese and nonobese women with complicated and uncomplicated pregnancies

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To investigate the role of placental abnormalities in complicated and uncomplicated pregnancies in obese women.

Methods

Placentas from patients with complicated or uncomplicated pregnancies and a pregravid body mass index (BMI) of ≥30 kg/m2 were analyzed histopathologically for lesions consistent with maternal and fetal circulation abnormalities and inflammatory lesions related to the maternal or fetal response. Findings were compared with a normal-weight control group matched by mode of delivery and presence/type of pregnancy complications.

Results

The obese group consisted of 28 women of whom 46 % had a complicated pregnancy. The obese group had a higher rate of maternal inflammatory lesions than the normal-weight control group (43 vs. 3.6 %, p < 0.001). There was no difference between the obese women with complicated and uncomplicated pregnancies in mean placental weight or lesions associated with fetal or maternal vascular supply.

Conclusion

Placental inflammatory lesions may underlie the worse pregnancy course of obese women relative to normal-weight women.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL (1998) Overweight and obesity in the United States: prevalence and trends, 1960–1994. Int J Obes Relat Metab Disord 22:39–47

    Article  PubMed  CAS  Google Scholar 

  2. Hedley AA, Ogden CL, Johnson CL, Carroll MD, Curtin LR, Flegal KM (2004) Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002. JAMA 291:2847–2850

    Article  PubMed  CAS  Google Scholar 

  3. Heslehurst N, Ells LJ, Simpson H, Batterham A, Wilkinson J, Summerbell CD (2007) Trends in maternal obesity incidence rates, demographic predictors, and health inequalities in 36,821 women over a 15-year period. BJOG 114:187–194

    Article  PubMed  CAS  Google Scholar 

  4. Sebire NJ, Jolly M, Harris JP, Wadsworth J, Joffe M, Beard RW, Regan L, Robinson S (2001) Maternal obesity and pregnancy outcome: a study of 287,213 pregnancies in London. Int J Obes Relat Metab Disord 25:1175–1182

    Article  PubMed  CAS  Google Scholar 

  5. Bhattacharya S, Campbell DM, Liston WA (2007) Effect of body mass index on pregnancy outcomes in nulliparous women delivering singleton babies. BMC Public Health 7:168

    Article  PubMed  Google Scholar 

  6. Yogev Y, Chen R, Ben-Haroush A, Hod M, Bar J (2010) Maternal overweight and pregnancy outcome in women with Type-1 diabetes mellitus and different degrees of nephropathy. J Matern Fetal Neonatal Med 23:999–1003

    Article  PubMed  Google Scholar 

  7. Drake AJ, Reynolds RM (2010) Impact of maternal obesity on offspring obesity and cardiometabolic disease risk. Reproduction 140:387–398

    Article  PubMed  CAS  Google Scholar 

  8. Roberts KA, Riley SC, Reynolds RM, Barr S, Evans M, Statham A, Hor K, Jabbour HN, Norman JE, Denison FC (2011) Placental structure and inflammation in pregnancies associated with obesity. Placenta 32:247–254

    Article  PubMed  CAS  Google Scholar 

  9. Ramsay JE, Ferrell WR, Crawford L, Wallace AM, Greer IA, Sattar N (2002) Maternal obesity is associated with dysregulation of metabolic, vascular, and inflammatory pathways. J Clin Endocrinol Metab 87:4231–4237

    Article  PubMed  CAS  Google Scholar 

  10. Challier JC, Basu S, Bintein T, Minium J, Hotmire K, Catalano PM, Hauguel-de Mouzon S (2008) Obesity in pregnancy stimulates macrophage accumulation and inflammation in the placenta. Placenta 29:274–281

    Article  PubMed  CAS  Google Scholar 

  11. Denison FC, Roberts KA, Barr SM, Norman JE (2010) Obesity, pregnancy, inflammation, and vascular function. Reproduction 140:373–385

    Article  PubMed  CAS  Google Scholar 

  12. Kovo M, Schreiber L, Ben-Haroush A, Asalee L, Seadia S, Golan A, Bar J (2011) The placental factor in spontaneous preterm labor with and without premature rupture of membranes. J Perinat Med 39:423–429

    Article  PubMed  Google Scholar 

  13. Moore TR (2004) Adolescent and adult obesity in women: a tidal wave just beginning. Clin Obstet Gynecol 47:884–889 discussion 980–981

    Article  PubMed  Google Scholar 

  14. Dollberg S, Haklai Z, Mimouni FB, Gorfein I, Gordon ES (2005) Birth weight standards in the live-born population in Israel. Isr Med Assoc J 7:311–314

    PubMed  Google Scholar 

  15. Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy (2000) Am J Obstet Gynecol 183:S1–S22 (no authors listed)

    Google Scholar 

  16. Kovo M, Schreiber L, Ben-Haroush A, Klien H, Wand S, Golan A, Bar J (2001) Association of non-reassuring fetal heart rate and fetal acidosis with placental histopathology. Placenta 32:450–453

    Article  Google Scholar 

  17. Kovo M, Schreiber L, Ben-Haroush A, Shor S, Golan A, Bar J (2011) Intrapartum fever at term: clinical characteristics and placental pathology. J Matern Fetal Neonatal Med (Epub ahead of print)

  18. Kovo M, Schreiber L, Ben-Haroush A, Wand S, Golan A, Bar J (2010) Placental vascular lesion differences in pregnancy-induced hypertension and normotensive fetal growth restriction. Am J Obstet Gynecol 202(561):e1–e5

    PubMed  Google Scholar 

  19. Pinar H, Sung CJ, Oyer CE, Singer DB (1996) Reference values for singleton and twin placental weights. Pediatr Pathol Lab Med 16:901–907

    PubMed  CAS  Google Scholar 

  20. Redline RW (2008) Placental pathology: a systematic approach with clinical correlations. Placenta 29 Suppl A:S86–S91

    Google Scholar 

  21. Redline RW, Heller D, Keating S, Kingdom J (2005) Placental diagnostic criteria and clinical correlation—a workshop report. Placenta 26(Suppl A):S114–S117

    Article  PubMed  Google Scholar 

  22. Schmatz M, Madan J, Marino T, Davis J (2010) Maternal obesity: the interplay between inflammation, mother and fetus. J Perinatol 30:441–446

    Article  PubMed  CAS  Google Scholar 

  23. Stewart FM, Freeman DJ, Ramsay JE, Greer IA, Caslake M, Ferrell WR (2007) Longitudinal assessment of maternal endothelial function and markers of inflammation and placental function throughout pregnancy in lean and obese mothers. J Clin Endocrinol Metab 92:969–975

    Article  PubMed  CAS  Google Scholar 

  24. Roberts VH, Smith J, McLea SA, Heizer AB, Richardson JL, Myatt L (2009) Effect of increasing maternal body mass index on oxidative and nitrative stress in the human placenta. Placenta 30:169–175

    Article  PubMed  CAS  Google Scholar 

  25. Radaelli T, Lepercq J, Varastehpour A, Basu S, Catalano PM, Hauguel-De Mouzon S (2009) Differential regulation of genes for fetoplacental lipid pathways in pregnancy with gestational and type 1 diabetes mellitus. Am J Obstet Gynecol 201(2):209.e1–209.e10

    Google Scholar 

  26. Bowen JM, Chamley L, Keelan JA, Mitchell MD (2002) Cytokines of the placenta and extra-placental membranes: roles and regulation during human pregnancy and parturition. Placenta 23:257–273

    Article  PubMed  CAS  Google Scholar 

  27. Khong Y, Brosens I (2011) Defective deep placentation. Best Pract Res Clin Obstet Gynaecol 25:301–311

    Article  PubMed  Google Scholar 

  28. Eckel RH, Grundy SM, Zimmet PZ (2005) The metabolic syndrome. Lancet 365:1415–1428

    Article  PubMed  CAS  Google Scholar 

  29. Ben-Ami S, Oron G, Ben-Haroush A, Blickstein D, Hod M, Bar J (2010) Primary atherothrombotic occlusive vascular events in premenopausal women with history of adverse pregnancy outcome. Thromb Res 125:124–127

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

The authors report no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, The Edith Wolfson Medical Center, P.O. Box 5, 58100, Holon, Israel

    Jacob Bar, Elena Saruhanov, Abraham Golan & Michal Kovo

  2. Department of Pathology, The Edith Wolfson Medical Center, Holon, Israel

    Letizia Schreiber

  3. Department of Obstetrics and Gynecology, Rabin Medical Center, Petach Tikva, Israel

    Avi Ben-Haroush

  4. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Jacob Bar, Letizia Schreiber, Elena Saruhanov, Avi Ben-Haroush, Abraham Golan & Michal Kovo

Authors
  1. Jacob Bar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Letizia Schreiber
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Elena Saruhanov
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Avi Ben-Haroush
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Abraham Golan
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Michal Kovo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michal Kovo.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bar, J., Schreiber, L., Saruhanov, E. et al. Placental histopathological findings in obese and nonobese women with complicated and uncomplicated pregnancies. Arch Gynecol Obstet 286, 1343–1347 (2012). https://doi.org/10.1007/s00404-012-2450-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-012-2450-z

Keywords

Search

Navigation