Histopathological Evaluation of Placental Changes in Women with Excessive Gestational Weight Gain
Abstract
Objective: Excessive weight gain during pregnancy has been associated with adverse maternal and fetal outcomes; however, its effects on placental histomorphology remain incompletely characterized. The present study aimed to evaluate placental histopathological alterations in women who gained excessive weight during pregnancy using Hematoxylin–Eosin (H&E) staining.
Materials and Methods: Placental tissues were obtained postpartum from 45 normal-weight pregnant women (BMI <30 kg/m²) and 45 women with excessive gestational weight gain/obesity (BMI ≥30 kg/m²). All samples underwent routine histological processing and were stained with H&E. Placental sections were examined under light microscopy for villous architecture, syncytiotrophoblast integrity, stromal changes, fibrin deposition, vascular congestion, and syncytial knot formation.
Results: Placentae from the control group exhibited preserved villous architecture, intact syncytiotrophoblast layers, and normal stromal and vascular morphology. In contrast, placentae from the high-BMI group demonstrated marked histopathological alterations, including villous structural disorganization, stromal degeneration, increased fibrin deposition, prominent vascular congestion, and an increased number of syncytial knots.
Conclusion: Excessive weight gain during pregnancy is associated with significant placental histomorphological alterations detectable by routine H&E staining. These structural changes may reflect impaired uteroplacental circulation and reduced placental functional capacity, potentially contributing to an adverse intrauterine environment.
Keywords: Gestational weight gain, placenta, hematoxylin–eosin, histopathology, villous degeneration
Keywords:
Gestational weight gain, placenta, hematoxylin–eosin, histopathology, villous degenerationDOI
https://doi.org/10.22270/jddt.v16i2.7574References
1. Burton GJ, Jauniaux E. What is the placenta? Am J Obstet Gynecol. 2015;213(4 Suppl):S6-S8. https://doi.org/10.1016/j.ajog.2015.07.050 PMid:26428504
2. Benirschke K, Burton GJ, Baergen RN. Pathology of the Human Placenta. 6th ed. New York: Springer; 2012. https://doi.org/10.1007/978-3-642-23941-0 PMCid:PMC3381679
3. Poston L, Caleyachetty R, Cnattingius S, Corvalán C, Uauy R, Herring S, Gillman MW. Preconceptional and maternal obesity: epidemiology and health consequences. Lancet Diabetes Endocrinol. 2016;4(12):1025-1036. https://doi.org/10.1016/S2213-8587(16)30217-0 PMid:27743975
4. Institute of Medicine (US); National Research Council. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington (DC): National Academies Press; 2009.
5. Desoye G. The human placenta in diabetes and obesity: friend or foe? Diabetes Care. 2018;41(7):1362-1369. https://doi.org/10.2337/dci17-0045 PMid:29934479
6. Kristiansen O, Roland MC, Zucknick M, Reine TM, Kolset SO, Henriksen T, Lekva T, Michelsen T. Maternal body mass index and placental weight: a role for fetal insulin, maternal insulin and leptin. J Endocrinol Invest. 2022;45(11):2105-2121. https://doi.org/10.1007/s40618-022-01842-2 PMid:35781790 PMCid:PMC9525437
7. Challier JC, Basu S, Bintein T, Minium J, Hotmire K, Catalano PM, Hauguel-de Mouzon S. Obesity in pregnancy stimulates macrophage accumulation and inflammation in the placenta. Placenta. 2008;29(3):274-281. https://doi.org/10.1016/j.placenta.2007.12.010 PMid:18262644 PMCid:PMC4284075
8. Mayhew TM. A stereological perspective on placental morphology in normal and complicated pregnancies. J Anat. 2009;215(1):77-90. https://doi.org/10.1111/j.1469-7580.2008.00994.x PMid:19141109 PMCid:PMC2714641
9. Kelly AC, Powell TL, Jansson T. Placental function in maternal obesity. Clin Sci (Lond). 2020;134(8):961-984. https://doi.org/10.1042/CS20190266 PMid:32313958 PMCid:PMC8820171
10. Brouwers L, Franx A, Vogelvang TE, Houben ML, van Rijn BB, Nikkels PG. Association of maternal prepregnancy body mass index with placental histopathological characteristics in uncomplicated term pregnancies. Pediatr Dev Pathol. 2019;22(1):45-52. https://doi.org/10.1177/1093526618785838 PMid:29969058 PMCid:PMC6604681
11. Redman CW, Sargent IL. Placental stress and pre-eclampsia: a revised view. Placenta. 2009;30 Suppl A:S38-S42. https://doi.org/10.1016/j.placenta.2008.11.021 PMid:19138798
12. Kingdom JC, Kaufmann P. Oxygen and placental villous development: origins of fetal hypoxia. Placenta. 1997;18(8):613-621. https://doi.org/10.1016/S0143-4004(97)90000-X PMid:9364596
13. Burton GJ, Jauniaux E. Oxidative stress. Best Pract Res Clin Obstet Gynaecol. 2011;25(3):287-299. https://doi.org/10.1016/j.bpobgyn.2010.10.016 PMid:21130690 PMCid:PMC3101336
14. Friis CM, Roland MC, Godang K, Voldner N, Bollerslev J, Henriksen T. Adiposity-related inflammation: effects of pregnancy. Obesity (Silver Spring). 2013;21(1):E124-E130. https://doi.org/10.1002/oby.20120 PMid:23505192
15. Huppertz B. The anatomy of the normal placenta. J Clin Pathol. 2008;61(12):1296-1302. https://doi.org/10.1136/jcp.2008.055277 PMid:18755720
16. Benirschke K, Kaufmann P. Pathology of the Human Placenta. 5th ed. New York: Springer; 2006.
17. Santos ED, Hernández MH, Sérazin V, Vialard F, Dieudonné MN. Human placental adaptive changes in response to maternal obesity: sex specificities. Int J Mol Sci. 2023;24(11):9770. https://doi.org/10.3390/ijms24119770 PMid:37298720 PMCid:PMC10253453
18. Barker DJ. The fetal and infant origins of adult disease. BMJ. 1990;301(6761):1111. https://doi.org/10.1136/bmj.301.6761.1111 PMid:2252919 PMCid:PMC1664286
Published
Abstract Display: 159
PDF Downloads: 95
PDF Downloads: 16 How to Cite
Issue
Section
Copyright (c) 2026 Özkan Yükselmiş, Murat Akkuş , Fırat Aşır

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).

.