title: Sex specific adaptations in placental biometry of overweight and obese women.
abstract: BACKGROUND
  Placental biometry at birth has been shown to predict chronic disease in later life. We hypothesized that maternal overweight/obesity, a state of low-grade inflammation and risk factor for adverse pregnancy outcome, could negatively influence placental development and that differences would be sex-specific.
  
  
  METHODS
  696 women (537 normal-weight, NW; 112 overweight, OW; 47 obese, OB) with singleton uncomplicated pregnancies were prospectively enrolled at term delivery. Gestational age, maternal (age, height, pre-pregnancy BMI, gestational weight gain -GWG, hemoglobin, hematocrit and glycemia), fetal (weight, length, ponderal index, cranial circumference) and placental (weight, diameters) data were collected. Placental area, thickness and efficiency (fetal/placental weight ratio, F/P) were calculated.
  
  
  RESULTS
  GWG was within standard recommendations in OB, while OW exceeded it. Placental weight was significantly higher in OW versus NW, but not in OB, leading to significantly higher placental thickness and lower F/P in this group. In the total population, a significant interaction effect between maternal BMI and fetal sex on placental weight and efficiency was found. Indeed, differences in placental parameters were present only in female offspring.
  
  
  CONCLUSIONS
  In our population of OW and OB uncomplicated pregnancies only OW women, presenting GWG over standard recommendations, had thicker and less efficient placentas. We also reported different placental adaptation depending on fetal sex, with significant changes only in female fetuses. This may be part of a female-specific strategy aiming to ensure survival if another adverse event occurs. Customized counseling according to maternal BMI and fetal sex should be evaluated in clinical care.
authors.affiliation: Department of Mother and Child, Hospital L. Sacco, Department of Biomedical and Clinical Sciences L. Sacco, and Center for Fetal Research Giorgio Pardi, Università degli studi di Milano, Italy. Electronic address: chiara.mando@unimi.it.
authors.forename: Chiara
authors.initials: C
authors.lastname: Mandò
authors.affiliation: Department of Mother and Child, Hospital L. Sacco, Department of Biomedical and Clinical Sciences L. Sacco, and Center for Fetal Research Giorgio Pardi, Università degli studi di Milano, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Calabrese
authors.affiliation: Department of Mother and Child, Hospital L. Sacco, Department of Biomedical and Clinical Sciences L. Sacco, and Center for Fetal Research Giorgio Pardi, Università degli studi di Milano, Italy.
authors.forename: Martina Ilaria
authors.initials: MI
authors.lastname: Mazzocco
authors.affiliation: Department of Mother and Child, Hospital L. Sacco, Department of Biomedical and Clinical Sciences L. Sacco, and Center for Fetal Research Giorgio Pardi, Università degli studi di Milano, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Novielli
authors.affiliation: Department of Mother and Child, Hospital L. Sacco, Department of Biomedical and Clinical Sciences L. Sacco, and Center for Fetal Research Giorgio Pardi, Università degli studi di Milano, Italy.
authors.forename: Gaia Maria
authors.initials: GM
authors.lastname: Anelli
authors.affiliation: Department of Mother and Child, Hospital L. Sacco, Department of Biomedical and Clinical Sciences L. Sacco, and Center for Fetal Research Giorgio Pardi, Università degli studi di Milano, Italy.
authors.forename: Patrizio
authors.initials: P
authors.lastname: Antonazzo
authors.affiliation: Department of Mother and Child, Hospital L. Sacco, Department of Biomedical and Clinical Sciences L. Sacco, and Center for Fetal Research Giorgio Pardi, Università degli studi di Milano, Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: Cetin
mesh_terms: D000222:Adaptation, Physiological / Q000502:physiology*; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D047109:Fetal Development / Q000502:physiology; D005333:Fetus / Q000502:physiology; D006801:Humans; D008297:Male; D009765:Obesity / Q000473:pathology* / Q000503:physiopathology; D050177:Overweight / Q000473:pathology* / Q000503:physiopathology; D010920:Placenta / Q000473:pathology* / Q000502:physiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000473:pathology* / Q000503:physiopathology; D012737:Sex Factors; D015430:Weight Gain / Q000502:physiology
keywords: BMI; Fetal gender; Obesity; Placenta; Placental efficiency; Pregnancy