title: Stereology of the placenta in type 1 and type 2 diabetes.
abstract: OBJECTIVE
  To assess by stereology the placental structure in type 1 (T1DM) and type 2 (T2DM) diabetic pregnancies compared to normal non-diabetic (ND) controls.
  
  
  METHODS
  Prospective case control study. Placentae were sampled in a systematic random fashion. Stereological analysis was performed using a computerised stereology programme (Image Pro 6.2, Media Cybernetics, Inc, Silver Spring MD, USA). Participants were matched for gender of infant and mode of delivery.
  
  
  METHODS
  Volume, length and surface area of placental components; clinical outcome.
  
  
  RESULTS
  Ten ND, eight T2DM and ten T1DM women consented to the study. There was no difference between the groups regarding maternal age, neonatal birth weight, or placental weight. On stereological examination, terminal villous volume was significantly increased in both diabetic groups compared to ND controls. Capillary volume and length was increased in T1DM pregnancies compared to ND and T2DM. Capillary length was increased in both diabetic groups compared to ND. When all diabetic groups were compared based on severity of glycaemia those with poor glycaemic control (HbA1c>7%) had higher placental capillary volume than those with good glycaemic control.
  
  
  CONCLUSIONS
  This study demonstrates an association between maternal diabetes and increased terminal villous volume. Additionally capillary volume and length is increased in the placentae of normally grown infants of T1DM diabetic mothers compared to non-diabetic controls. Maternal glycaemia appears to influence capillary, but not stromal, development. This suggests that factors other than glycaemia have a role in placental development in pre-gestational diabetes.
authors.affiliation: UCD Obstetrics and Gynaecology, School of Medicine and Medical Science, University College Dublin, National Maternity Hospital, Dublin, Ireland.
authors.forename: M
authors.initials: M
authors.lastname: Higgins
authors.forename: P
authors.initials: P
authors.lastname: Felle
authors.forename: E E
authors.initials: EE
authors.lastname: Mooney
authors.forename: J
authors.initials: J
authors.lastname: Bannigan
authors.forename: F M
authors.initials: FM
authors.lastname: McAuliffe
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002196:Capillaries / Q000473:pathology; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1; D003924:Diabetes Mellitus, Type 2; D005260:Female; D006801:Humans; D008297:Male; D010920:Placenta / Q000033:anatomy & histology* / Q000098:blood supply / Q000473:pathology*; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000473:pathology*; D011446:Prospective Studies
chemical_list: D001786:Blood Glucose