The maternal body mass index and first-trimester placental (vascular) development

IF 3 2区医学 Q2 DEVELOPMENTAL BIOLOGY

Placenta Pub Date : 2025-02-01 DOI:10.1016/j.placenta.2024.12.015

Nicole Schenkelaars , Sam Schoenmakers , Marijke M. Faas , Sten P. Willemsen , Eline S. de Vos , Régine P.M. Steegers-Theunissen

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引用次数: 0

Abstract

Background

Maternal obesity is associated with maternal complications, including hypertensive disorders of pregnancy (HDP), and related fetal complications, such as fetal growth restriction. During pregnancy, the placenta is one of the key regulators of embryonic and fetal growth. Previous studies mainly investigated placental growth by measuring postpartum placental weight. However, the effects of obesity on aberrant placental and fetal growth might occur already in the first trimester.

Objectives

Investigate associations between maternal BMI and first-trimester features of placental size and vascular development.

Study design

870 women were included from a prospective cohort study. BMI was measured <10 weeks of gestation. Transvaginal 3D Power Doppler ultrasounds were obtained at 7, 9, and 11 weeks of gestation to measure placental volume (PV) and utero-placental vascular volume (uPVV). Associations between BMI and utero-placental (vascular) volume trajectories were assessed using mixed models, adjusted for covariates.

Results

Associations were found between maternal BMI and PV (non-linear model; p = 0.022). A BMI ≥34 kg/m² showed decreased first-trimester PV compared to normal weight (Δ∛PV=−0.070, 95%CI -0.136 to −0.004, p=0.039). Negative associations were found between maternal BMI and uPVV (β=−0.027, 95%CI -0.041 to −0.014, p<0.001). Exclusion of women developing HDP, attenuated the association with PV (non-linear model; p=0.152), whilst the association between uPVV remained (β=−0.031, 95%CI -0.046 to −0.016, p=0.001).

Conclusion

Increased maternal BMI is associated with decreasing first-trimester uPVV, moreover, in women with a BMI ≥34 kg/m² the PV is decreased. These findings suggest tissue-specific changes in the placental development of women with obesity.

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母体体重指数与妊娠早期胎盘（血管）发育。

背景：产妇肥胖与产妇并发症相关，包括妊娠期高血压疾病（HDP）和相关胎儿并发症，如胎儿生长受限。在怀孕期间，胎盘是胚胎和胎儿生长的关键调节器之一。以往的研究主要通过测量产后胎盘重量来研究胎盘的生长。然而，肥胖对胎盘和胎儿异常生长的影响可能早在妊娠早期就已经发生了。目的：探讨母体体重指数与妊娠早期胎盘大小和血管发育的关系。研究设计：870名女性纳入前瞻性队列研究。结果：产妇BMI与PV(非线性模型；p = 0.022)。BMI≥34 kg/m2与正常体重相比，妊娠早期PV降低（Δ∛PV=-0.070, 95%CI -0.136 ~ -0.004, p=0.039）。孕妇BMI与uPVV呈负相关（β=-0.027, 95%CI为-0.041 ~ -0.014）。结论：孕妇BMI升高与妊娠早期uPVV降低相关，且BMI≥34 kg/m2的孕妇uPVV降低。这些发现表明，肥胖妇女的胎盘发育存在组织特异性变化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Placenta 医学-发育生物学

CiteScore

6.30

自引率

10.50%

发文量

391

审稿时长

78 days

期刊介绍： Placenta publishes high-quality original articles and invited topical reviews on all aspects of human and animal placentation, and the interactions between the mother, the placenta and fetal development. Topics covered include evolution, development, genetics and epigenetics, stem cells, metabolism, transport, immunology, pathology, pharmacology, cell and molecular biology, and developmental programming. The Editors welcome studies on implantation and the endometrium, comparative placentation, the uterine and umbilical circulations, the relationship between fetal and placental development, clinical aspects of altered placental development or function, the placental membranes, the influence of paternal factors on placental development or function, and the assessment of biomarkers of placental disorders.