Abstract
BACKGROUND: The relevance of the problem of obesity is associated with the high frequency and steady growth of this pathology in the population. The epigenetic influence of maternal obesity on the course of pregnancy and childbirth, as well as on the condition of the fetus and newborn, is currently being studied. This article analyzes changes in the composition of the connective tissue of the placenta against the background of obesity in pregnant and puerperas. AIM: The aim of this study is to identify the pathomorphological features of the placenta and the composition of placental collagens in women who were obese before pregnancy and at the time of delivery at the Perinatal Center of St. Petersburg State Medical University from 2018 to 2021 to assess potential fetal risks and to predict possible complications during pregnancy and in the postnatal period for the mother. MATERIALS AND METHODS: A histological examination of the placentas of obese women (18 patients) and the ones with a normal body mass index (18 patients) who gave birth to mature newborns at the Perinatal Center of St. Petersburg State Medical University from 2018 to 2021 was performed followed by immunohistochemical examination. Staining of placenta specimens was carried out in accordance with the standard immunohistochemical protocol, using primary antibodies to type I–IV collagen. RESULTS: Microscopic examination of chorionic villi revealed no significant differences in the presence of chronic inflammation and angiogenesis disorders between the groups. When studying collagen expression levels, the following differences have been found: in the group of pregnant obese patients, the optical luminescence density and distribution area for type I–III collagen in the placenta were significantly higher, while for type IV collagen they were significantly lower compared with the control group. CONCLUSIONS: The following features of the formation of connective tissue in the placenta in obese mothers have been revealed: an increase in type I–III collagen production and a decrease in type IV collagen production. The obtained findings indicate an earlier functional and morphological change in the placenta than those detected by standard histological methods.
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