Morphological features of the placenta in obese women

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Abstract

Hypothesis/Aims of study. Obesity and severe chronic somatic pathology in a woman leads to a rapid depletion of compensatory and adaptive reserves of the placenta and to the progression of circulatory and dystrophic changes, which causes intrauterine growth retardation and reduces the likelihood of a favorable course of pregnancy and childbirth. The aim of this study was to assess the morphological features of the vascular component of placental villi in obese women.

Study design, materials and methods. Histological and immunohistochemical studies were conducted on 41 placentas from obese patients with and without gestational diabetes mellitus and from healthy patients, endothelial marker CD34+ expression being assessed in chorionic villi.

Results. In obese patients, chronic placental insufficiency is presented in most cases as a dissociated form with persistence of not only mature but also immature villi, which indicates early structural pathology of the placenta.

Conclusion. Obesity in women contributes to more frequent chronic placental insufficiency with severe circulatory disorders and varying degrees of severity of compensatory and adaptive changes.

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About the authors

Darya S. Seryogina

The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott

Author for correspondence.
Email: dunyashadasha00@gmail.com
ORCID iD: 0000-0002-6496-586X
SPIN-code: 2852-3281

MD, Postgraduate Student. The Delivery Department

Russian Federation, Saint Petersburg

Alexandra K. Sosnina

The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott

Email: aleksandrasosnina@bk.ru
ORCID iD: 0000-0002-9353-9333

MD, PhD

Russian Federation, Saint Petersburg

Tatyana G. Tral

The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott

Email: ttg.tral@yandex.ru
ORCID iD: 0000-0001-8948-4811
Scopus Author ID: 37666260400

MD, PhD, Head of the Pathology Department

Russian Federation, Saint Petersburg

Gulrukhsor Kh. Tolibova

The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott

Email: gulyatolibova@yandex.ru
ORCID iD: 0000-0002-6216-6220
SPIN-code: 7544-4825
Scopus Author ID: 23111355700

MD, PhD, DSci (Medicine), Leading Researcher, Head of the Laboratory of Immunohistochemistry

Russian Federation, Saint Petersburg

Elena V. Mozgovaya

The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott; Saint Petersburg State University

Email: elmozg@mail.ru
ORCID iD: 0000-0002-6460-6816
SPIN-code: 5622-5674

MD, PhD, DSci (Medicine), Head of the Department of Obstetrics and Perinatology; Professor. The Department of Obstetrics, Gynecology, and Reproductive Sciences, the Faculty of Medicine

Russian Federation, Saint Petersburg

References

  1. Диагностика и лечение ожирения у взрослых. Проект рекомендаций экспертного комитета Российской ассоциации эндокринологов // Ожирение и метаболизм. − 2010. – Т. 7. − № 1. – С. 76−81. [Diagnostika i lechenie ozhireniya u vzroslykh. Proekt rekomendatsii ehkspertnogo komiteta Rossiiskoi assotsiatsii ehndokrinologov. Obesity and metabolism. 2010;7(1):76-81. (In Russ.)]
  2. Yumuk V, Tsigos C, Fried M, et al. European guidelines for obesity management in adults. Obes Facts. 2015;8(6):402-424. https://doi.org/10.1159/000442721.
  3. Aviram A, Hod M, Yogev Y. Maternal obesity: Implications for pregnancy outcome and long-term risks – a link to maternal nutrition. Int J Gynaecol Obstet. 2011;(115 Suppl 1):S6-S10. https://doi.org/10.1016/S0020-7292(11)60004-0.
  4. Дедов И.И., Мельниченко Г.А., Шестакова М.В., и др. Национальные клинические рекомендации по лечению морбидного ожирения у взрослых. 3-й пересмотр (Лечение морбидного ожирения у взрослых) // Ожирение и метаболизм. – 2018. – Т. 15. − № 1. – С. 53−70. [Dedov II, Melnichenko GA, Shestakova MV, et al. Russian national clinical recommendations for morbid obesity treatment in adults. 3rd revision (Morbid obesity treatment in adults). Obesity and metabolism 2018;15(1):53-70 (In Russ.)]. https://doi.org/10.14341/OMET2018153-70.
  5. Вахрушина А.С. Роль чрезмерной прибавки массы тела в формировании осложнений, определяющих тактику родоразрешения: дис. … канд. мед. наук. – М., 2020. – 122 с. [Vakhrushina AS. Rol’ chrezmernoi pribavki massy tela v formirovanii oslozhnenii, opredelyayushchikh taktiku rodorazresheniya. [dissertation] Moscow; 2020. 122 р. (In Russ.)]
  6. Красильникова Е.И., Баранова Е.И., Благосклонная Я.В., и др. Механизмы развития артериальной гипертензии у больных метаболическим синдромом // Артериальная гипертензия. – 2011. – Т. 17. − № 5. – С. 406−414. [Krasil’nikova EI, Baranova EI, Blagosklonnaya YaV, et al. Mechanisms of arterial hypertension in metabolic syndrome. Arterial hypertension. 2011;17(5):406-414. (In Russ.)]. https://doi.org/10.18705/1607-419X-2011-17-5-405-414.
  7. Kelly AC, Powell TL, Jansson T. Placental function in maternal obesity. Clin Sci (Lond). 2020;134(8):961-984. https://doi.org/10.1042/CS20190266.
  8. Калинкина О.Б., Спиридонова Н.В. Особенности состояния плаценты при преждевременных родах у пациенток с ожирением в современных экологических условиях // Известия Самарского научного центра Российской академии наук. – 2012. – Т. 14. − № 5-2. – С. 348−350. [Kalinkina OB, Spiridonova NV. Peculiarities of placental condition during preterm birth in overweight and obese women as related to ecology. Izvestiya Samarskogo nauchnogo tsentra Rossiiskoi akademii nauk. 2012;14(5-2):348-350. (In Russ.)]
  9. Калинкина О.Б., Спиридонова Н.В., Юнусова Ю.Р., Аравина О.Р. Многофакторный анализ риска развития акушерских и перинатальных осложнений у пациенток с ожирением и избыточной массой тела // Известия Самарского научного центра Российской академии наук. – 2015. – Т. 17. − № 5-3. – С. 793−797. [Kalinkina OB, Spiridonova NV, Yunusova YR, Aravina OR. Multifactorial risk analysis of gestational complications development and outcome of pregnancy in women with increased body mass index and obesity. Izvestiya Samarskogo nauchnogo tsentra Rossiiskoi akademii nauk. 2015;17(5-3):793-797. (In Russ.)]
  10. Глуховец Б.И., Глуховец Н.Г. Патология последа. – СПб.: ГРААЛЬ, 2002. – 448 с. [Gluhovec BI, Gluhovec NG. Patologiya posleda. Saint Petersburg: GRAAL; 2002. 448 р. (In Russ.)]
  11. Иванов Д.О., Петренко Ю.В., Кашменская В.Н. Особенности ангиогенеза у новорожденных с ЗВУР // Детская медицина Северо-Запада. – 2013. – Т. 4. – № 4. – С. 4–10. [Ivanov DO, Petrenko YuV, Kashmenskaya VN. Features angiogenesis in newborns with IUGR. Detskaya meditsina Severo-Zapada. 2013;4(4):4-10. (In Russ.)]
  12. Арутюнян А.В., Шестопалов А.В., Буштырева И.О., Микашинович З.И. Биохимические механизмы формирования плаценты при физиологической и осложненной беременности. – СПб., 2010. – 250 с. [Arutyunyan AV, Shestopalov AV, Bushtyreva IO, Mikashinovich ZI. Biokhimicheskie mekhanizmy formirovaniya platsenty pri fiziologicheskoi i oslozhnennoi beremennosti. Saint Petersburg; 2010. 250 р. (In Russ.)]
  13. Loardi C, Falchetti M, Prefumo F, et al. Placental morphology in pregnancies associated with pregravid obesity. J Matern Fetal Neonatal Med. 2016;29(16):2611-2616. https://doi.org/10.3109/14767058.2015.1094792.
  14. Brett KE, Ferraro ZM, Yockell-Lelievre J, et al. Maternal-fetal nutrient transport in pregnancy pathologies: The role of the placenta. Int J Mol Sci. 2014;15(9):16153-16185. https://doi.org/10.3390/ijms150916153.
  15. Blann AD, Woywodt A, Bertolini F, et al. Circulating endothelial cells. Biomarker of vascular disease. Thromb Haemost. 2005;93(2):228-235. https://doi.org/10.1160/TH04-09-0578.
  16. Hristov M, Erl W, Weber PC. Endothelial progenitor cells: Mobilization, differentiation, and homing. Arterioscler Thromb Vasc Biol. 2003;23(7):1185-1189. https://doi.org/ 10.1161/01.ATV.0000073832.49290.B5.
  17. Shehzad A, Iqbal W, Shehzad O, Lee YS. Adiponectin: Regulation of its production and its role in human diseases. Hormones (Athens). 2012;11(1):8-20. https://doi.org/10.1007/BF03401534.
  18. Asahara T, Murohara T, Sullivan A, et al. Isolation of putative progenitor endothelial cells for angiogenesis. Science. 1997;275(5302):964-967. https://doi.org/10.1126/science. 275.5302.964.
  19. Chopp M, Li Y. Stimulation of plasticity and functional recovery after stroke – cell-based and pharmacological therapy. Eur Neurol Rev. 2011;6(2):97-100. http://doi.org/10.17925/ENR.2011.06.02.97.
  20. Jung KH, Roh JK. Circulating endothelial progenitor cells in cerebrovascular disease. J Clin Neurol. 2008;4(4):139-147. https://doi.org/10.3988/jcn.2008.4.4.139.
  21. Чабанова Н.Б., Василькова Т.Н., Полякова В.А. Влияние индекса массы тела и чрезмерной прибавки веса при беременности на риск рождения крупного плода // Журнал научных статей «Здоровье и образование в XXI веке». Серия «Медицина». – 2018. – Т. 20. − № 7. – С. 15−18. [Chabanova NB, Vasilkova TN, Polyakova VA. The influence of body mass index and excessive gestational weight gain on the risk of fetal macrosomia. Health & education millennium. Series “Medicine”. 2018;20(7):15-18. (In Russ.)]. http://dx.doi.org/10.26787/nydha-2226-7425-2018-20-7-15-18.
  22. Писаренко Е.А., Слобожанина Е.И., Камышников В.С. Комплексное исследование метаболического состояния эндотелия, структурно-функциональных свойств эритроцитов и липидного спектра сыворотки крови как потенциальных факторов формирования ангиогемических фетоплацентарных нарушений у беременных с ожирением // Лабораторная диагностика. Восточная Европа. – 2014. – № 2. – С. 46−61. [Pisarenko EA, Slobozhanina EI, Kamyshnikov VS. A comprehensive study of the metabolic state of the endothelium, structural and functional properties of red blood cells and serum lipid spectrum as potential factors of formation of angio-hematological fetoplacental disorders in pregnant women with obesity. Laboratory diagnostics. Eastern Europe. 2014;(2):46-61. (In Russ.)]

Supplementary files

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2. Fig. 1. Placental villous tree structure at full-term gestation (hematoxylin and eosin staining at ×400 magnification): a, terminal villi; b, terminal villi and abundant syncytial outgrowths on chorionic villi

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3. Fig. 2. Chronic placental insufficiency (hematoxylin and eosin staining at ×100 magnification): a, persistence of immature intermediate chorionic villi and severe circulatory disorders; b, hypervascularization and plethora of chorionic villi

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4. Fig. 3. CD34+ expression in chorionic villi (immunohistochemistry staining at ×200 magnification): a, control group; b, group with obesity and no gestational diabetes mellitus

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5. Fig. 4. Area of CD34+ expression in the placentas in the study groups. * p < 0.01, ** p < 0.001 comparing to the control group

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Copyright (c) 2021 Seryogina D.S., Sosnina A.K., Tral T.G., Tolibova G.K., Mozgovaya E.V.

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия Эл № 77 - 6389 от 15.07.2002 г.


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