Does obesity affect the frequency or severity of acute placental inflammation at term?

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Conference Proceeding

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Publication Title

Obstet Gynecol


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.



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