Maedica · 2026
Comparative Study of Histomorphological Parameters and Pro-Inflammatory Cytokine Interleukin-6 Gene Expression in the Placenta of Pre-Pregnancy Obese and Normal-Weight Mothers.
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Bhardwaj Nikha, Sharma Charu, Sankanagoudar Shrimanjunath, Ghatak Surajit, Banerjee Mithu, Jakhar Atul, Singh Pratibha, Dixit Shilpi G
Аннотация
BACKGROUND: Obesity is an independent driver of detrimental health outcomes and its prevalence among urban women of reproductive age is rising globally. This study aimed to examine the influence of pre-pregnancy body mass index (BMI) on the feto-maternal interface, with particular focus on placental histomorphometry and IL-6 gene expression.
METHODS: We conducted a comparative observational study among 66 pregnant women who were prospectively enrolled during the first trimester. Participants were classified into two groups according to their pre-pregnancy BMI using Asian BMI criteria: pre-pregnancy obese (n=33; BMI ≥25 Kg/m2) and normal weight (n=33; BMI 18.0-22.9 Kg/m2). Women with multifetal gestation, pre-existing diabetes mellitus, chronic hypertension, endocrine disorders and unavailable pre-pregnancy weight were excluded. Participants who developed gestational diabetes mellitus (GDM) or pregnancy-induced hypertension (PIH) during follow-up were also excluded. Placental histomorphological parameters and IL-6 gene expression were assessed after delivery.
RESULTS: Placentas from the pre-pregnancy obese group showed significant increases in physical dimensions, including mean diameter (17.40 cm ± 0.52), thickness (3.37 cm ± 0.27) and weight (513.24 g ± 11.67). Histological changes included increased syncytial knotting (69.7%), villous fibrinoid necrosis (54.5%), hypovascularity (51.5%) and stromal fibrosis (45.5%), with significant differences being compared with the normal-weight group. The IL-6 gene expression was also significantly higher in placentas from the obese group.
CONCLUSION: Pre-pregnancy obesity was associated with placental structural abnormalities and increased IL-6 gene expression in this study, even among women without pre-existing diabetes or hypertension and after excluding those who developed GDM or PIH. These findings suggest that maternal adiposity may be associated with placental stress and altered placental morphology. These observations underscore the potential importance of preconception weight assessment and management in optimizing maternal and neonatal health.
METHODS: We conducted a comparative observational study among 66 pregnant women who were prospectively enrolled during the first trimester. Participants were classified into two groups according to their pre-pregnancy BMI using Asian BMI criteria: pre-pregnancy obese (n=33; BMI ≥25 Kg/m2) and normal weight (n=33; BMI 18.0-22.9 Kg/m2). Women with multifetal gestation, pre-existing diabetes mellitus, chronic hypertension, endocrine disorders and unavailable pre-pregnancy weight were excluded. Participants who developed gestational diabetes mellitus (GDM) or pregnancy-induced hypertension (PIH) during follow-up were also excluded. Placental histomorphological parameters and IL-6 gene expression were assessed after delivery.
RESULTS: Placentas from the pre-pregnancy obese group showed significant increases in physical dimensions, including mean diameter (17.40 cm ± 0.52), thickness (3.37 cm ± 0.27) and weight (513.24 g ± 11.67). Histological changes included increased syncytial knotting (69.7%), villous fibrinoid necrosis (54.5%), hypovascularity (51.5%) and stromal fibrosis (45.5%), with significant differences being compared with the normal-weight group. The IL-6 gene expression was also significantly higher in placentas from the obese group.
CONCLUSION: Pre-pregnancy obesity was associated with placental structural abnormalities and increased IL-6 gene expression in this study, even among women without pre-existing diabetes or hypertension and after excluding those who developed GDM or PIH. These findings suggest that maternal adiposity may be associated with placental stress and altered placental morphology. These observations underscore the potential importance of preconception weight assessment and management in optimizing maternal and neonatal health.