Maternal Obesity Influences Placental Nutrient Transport, Inflammatory Status, and Morphology in Human Term Placenta

J Clin Endocrinol Metab. 2021 Mar 25;106(4):e1880-e1896. doi: 10.1210/clinem/dgaa660.

Abstract

Context: Maternal obesity has a significant impact on placental development. However, this impact on the placenta's structure and function (ie, nutrient transport and hormone and cytokine production) is a controversial subject.

Objective: We hypothesized that maternal obesity is associated with morphologic, secretory, and nutrient-related changes and elevated levels of inflammation in the placenta.

Design: We collected samples of placental tissue from 2 well-defined groups of pregnant women from 2017 to 2019. We compared the 2 groups regarding placental cytokine and hormone secretion, immune cell content, morphology, and placental nutrient transporter expressions.

Setting: Placenta were collected after caesarean section performed by experienced clinicians at Centre Hospitalier Intercommunal (CHI) of Poissy-Saint-Germain-en-Laye.

Patients: The main inclusion criteria were an age between 27 and 37 years old, no complications of pregnancy, and a first-trimester body mass index of 18-25 kg/m2 for the nonobese (control) group and 30-40 kg/m2 for the obese group.

Results: In contrast to our starting hypothesis, we observed that maternal obesity was associated with (1) lower placental IL-6 expression and macrophage/leukocyte infiltration, (2) lower placental expression of GLUT1 and SNAT1-2, (3) a lower placental vessel density, and (4) lower levels of placental leptin and human chorionic gonadotropin production.

Conclusion: These results suggest that the placenta is a plastic organ and could optimize fetal growth. A better understanding of placental adaptation is required because these changes may partly determine the fetal outcome in cases of maternal obesity.

Keywords: inflammatory status; maternal obesity; morphology; placental nutrient transport.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cesarean Section
  • Female
  • France
  • Humans
  • Inflammation / etiology*
  • Inflammation / metabolism
  • Inflammation / pathology
  • Nutrients / pharmacokinetics*
  • Obesity, Maternal* / complications
  • Obesity, Maternal* / metabolism
  • Obesity, Maternal* / pathology
  • Obesity, Maternal* / surgery
  • Organ Size
  • Placenta* / metabolism
  • Placenta* / pathology
  • Pregnancy
  • Pregnancy Complications / etiology
  • Pregnancy Complications / metabolism
  • Pregnancy Complications / pathology
  • Pregnancy Complications / surgery
  • Term Birth / physiology