Placental maternal and fetal vascular circulation in healthy non-obese and metabolically healthy obese pregnant women.

BACKGROUND AND AIMS: We investigated placental histopathology for lesions that are associated with maternal and fetal circulation abnormalities in obese pregnant women with and without metabolic alterations.

METHODS

332 pregnant women were divided into three groups: Group 1 included 163 non-obese metabolically healthy (NOMH), Group 2 106 obese metabolically healthy (OMH), and Group 3 63 obese metabolically abnormal (OMA) subjects, respectively.

RESULTS

Fetal vascular supply (FVS) abnormalities and Willous maturation defect (WMD) rate were higher in obese subjects without metabolic abnormalities, compared to NOMH subjects (p < 0.021 and p < 0.018, respectively). In the logistic regression analysis, obesity emerged as a significant independent predictor of FVS abnormalities (OR 1.54, 95% CI 1.193-1.992, p = 0.001) and WMD (OR 2.004, 95% CI 1.173-3.422, p = 0.011). Although maternal vascular supply (MVS) abnormalities differed significantly across groups (31%, 38% and 54% respectively, p < 0.005), in the logistic regression analysis, obesity was not significantly associated with MVS abnormalities.

CONCLUSIONS

We demonstrated that obesity, per se, is associated with an increased rate of placental vascular supply abnormalities and has a more adverse effect on fetal vascular circulation than on maternal vascular supply.