Does obesity affect the frequency or severity of acute placental inflammation at term?
Saeed H, Jacques S, and Qureshi F. Does obesity affect the frequency or severity of acute placental inflammation at term? Obstet Gynecol 2018; 131:24S.
Introduction: Histologic acute placental inflammation, particularly low stage inflammation, is a frequent finding at term. Much of it is sterile inflammation, and its causes are poorly understood. Maternal obesity, a proinflammatory condition associated with adverse obstetrical outcomes, may affect the frequency, stage, or grade of histologic placental acute maternal inflammatory response (MIR) and fetal inflammatory response (FIR) at term. Methods: Histologic acute MIR and FIR including stage (location of inflammation) and grade (severity of inflammation), were evaluated according to standardized criteria and compared in singleton placentas from 205 obese (BMI.30kg/m2) and 204 non-obese mothers, all deliv-ering at term with labor. Maternal medical records were reviewed. Results: MIR was present in 54% of the obese compared to 56% of the non-obese group (p5NS), while FIR was present in 38% of the obese compared to 34% of the non-obese group (p5NS). FIR stage.1 was more frequent in the obese group (25% vs 3%, p<0.001); however, there was no significant difference in MIR stage. MIR grade. 1 was more frequent in the obese group (13% vs 3%, p=0.005). FIR grade.1 was present in only 4 cases. Hypertension and diabetes were more frequent in the obese group, with no significant differences in other clinical features evaluated. The majority of mothers were African-American (80%). Conclusion: Histologic acute FIR stage. 1 and MIR grade. 1 were more frequent in the obese group suggesting that obesity may affect placental inflammation and supporting a role for systemic inflammation in adverse obstetrical outcomes associated with obesity.