Obesity during pregnancy: The findings, published in The Journal of Physiology, show that excess weight alters the structure of the placenta — a vital organ that nourishes the baby in the mother’s womb — more than poor glucose control in pregnancy.
The rates of obesity and gestational diabetes — the development of poor glucose — during pregnancy, are increasing worldwide.
While both are linked to multiple maternal and fetal complications, such as the increased risk of fetal death, stillbirth, infant death and higher infant birth weight, it was not known yet how these complications arise.
The study revealed that maternal obesity more than gestational diabetes reduced the formation of the placenta, its blood vessel density and surface area, and its ability to exchange nutrients between the mother and developing child.
Both obesity and gestational diabetes impact placental hormone production and inflammation markers, suggesting that the placenta is indeed functioning abnormally.
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The new insight enhances understanding of the mechanisms underlying poor pregnancy outcomes and the subsequent greater risk of poor neonatal and offspring health.
“As obesity and gestational diabetes often co-exist, the study highlights the importance of obesity over gestational diabetes in modulating placental structure and function, and begins to piece together how these placental changes may explain observed complications (For example – intrauterine death and stillbirths) and increased future non-communicable disease risk for both mother and baby,” said Professor Mushi Matjila from the University of Cape Town.
The identification of specific changes in the placenta could lead to the potential development of future placenta-targeted treatments or screening tests that may improve the health outcomes of the mother and offspring, particularly in low-middle income countries, the researchers from the University of Cambridge said.
The study looked at 71 women, of whom 52 were obese and 38 had developed gestational diabetes.
The study also acknowledged limitations such as a small sample size. With just 71 women it was not possible to determine what impact the sex of the fetus has on these placental changes. Thus it warrants further study.
