Placental pathology and fetal growth outcomes in pregnancies complicated by maternal obesity
Authors' conclusion
Presence of obesity in pregnancy is associated with increased rates of placental patterns of injury, decreased placental efficiency, and increased birthweight percentiles. While placental lesions, such as CV, have the potential to negatively impact fetal growth, the resulting birthweight percentiles demonstrate a more complex relationship between maternal obesity and fetal growth, that likely involves placental and fetal adaptation to the altered in utero environment.
Study context
- Population
- Maternal-infant dyads in the UCSD Obstetric Registry, 2011–2020
- Participants
- 1,366 maternal-infant dyads
- Exposure
- Maternal overweight and obesity vs lower maternal BMI
- Outcome
- Histopathologic patterns of placental injury and their consequences on fetal growth (birthweight percentiles)
Methodological detailsregistry-based, adjusted log-binomial and linear regression
- Registry-based
- Adjusted log-binomial and linear regression
Main finding
As reported in the abstract
- Placentas from mothers with overweight and obesity were heavier
- Higher adjusted RR of chronic villitis (CV), decidual vasculopathy, intervillous thrombosis and normoblastemia with overweight and obesity
- Placental efficiency (fetal-placental weight ratio) decreased with increasing BMI
- Maternal obesity associated with higher birthweight percentiles
- Multiple placental lesions, incl. MVM and fetal vascular malperfusion (FVM), had significant effects on birthweight percentiles; only MVM showed a differential effect by maternal obesity
- Adjusted for relevant confounders
Observational data: associations, not effects.
Further findings
- Maternal obesity associated with higher rates of preterm birth
Original publication
Placental pathology and fetal growth outcomes in pregnancies complicated by maternal obesity. Int J Obes (Lond). Published 31 May 2024. doi:10.
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