Three-dimensional digital reconstruction of human placental villus architecture in normal and complicated pregnancies.

Objective: This study aimed to examine the use of digital technology in the three-dimensional reconstruction of human placentas. Study design: Placentas obtained at term elective caesarean section were sampled, formalin-fixed and embedded in paraffin. Two hundred 5 mm consecutive sections were cut from each specimen and the resultant slides stained with haematoxylin and eosin. Slides were then scanned and the digitised images reconstructed using customised software. Results: Three-dimensional reconstructions were successfully achieved in placentas from normal pregnancies and those complicated by pre-eclampsia, growth restriction, and gestational diabetes. Marked morphological differences were readily identifiable, most clearly in the stem villus architecture. Conclusion: This method is an emerging research tool for examining placental histoarchitecture at high resolution and gaining clinically relevant insight into the placental pathology allied to pregnancy complications such as PET, IUGR and GD

The differential impact of maternal dietary macronutrient composition on offspring birthweight – results from the Danish National Birth Cohort

There is limited evidence about the differential impact of the dietary macronutrient composition (carbohydrate [CHO], protein and fat) during pregnancy on offspring birthweight(1,2). The aim of our study was to explore the association between maternal dietary macronutrient intake in the second trimester and offspring birthweight. The study included 63,755 mother-infant pairs within the Danish National Birth Cohort (DNBC)(3) in Denmark. Dietary data was collected in the food frequency questionnaires (FFQs) around the 25th week of gestation. Baseline information was collected from the participants at recruitment around the 12th week of gestation. Multiple linear regression models analysed the association between maternal macronutrient dietary intake in the second trimester and changes in birthweight. Both macronutrient models were mutually adjusted for energy contributing macronutrients. Model 1 was adjusted for confounders including pre-pregnancy body mass index (BMI), alcohol intake, smoking, parity, physical activity, dietary supplements, and competing exposures including gestational age at delivery, and sex of the offspring, and Model 2 was further adjusted for total micronutrient intakes (diet plus supplement) including calcium, iron, folate and vitamin B12. Results showed that each additional 100 g/day CHO and 30 g/day protein consumption in the second trimester were associated with higher birthweights of 14 g (95 % CI 9 to 20; P < 0·001) and 17 g (95 % CI −9 to 25; P < 0·001) respectively. Conversely, each additional 30 g/day fat consumption was associated with a lower birthweight of 23 g (95 % CI 18 to 27; P < 0·001). CHO and protein intakes in the second trimester are associated with improving birthweight, whereas fat is associated with limiting offspring weight gain. We advise an appropriate balance of dietary energy intake during pregnancy to optimise birthweight. 1. Moore VM, Davies MJ, Willson KJ et al. (2004) J Nutr 134, 1820–1826. 2. Chong MF-F, Chia AR, Colega M et al. (2015) J Nutr 145, 1303–1310. 3. Olsen J, Melbye M, Olsen SF et al. (2001) Scand J Public Health 29, 300–307

Genetic predisposition to hypertension is associated with preeclampsia in European and Central Asian women

Preeclampsia is a serious complication of pregnancy, affecting both maternal and fetal health. In genome-wide association meta-analysis of European and Central Asian mothers, we identify sequence variants that associate with preeclampsia in the maternal genome at ZNF831/20q13 and FTO/16q12. These are previously established variants for blood pressure (BP) and the FTO variant has also been associated with body mass index (BMI). Further analysis of BP variants establishes that variants at MECOM/3q26, FGF5/4q21 and SH2B3/12q24 also associate with preeclampsia through the maternal genome. We further show that a polygenic risk score for hypertension associates with preeclampsia. However, comparison with gestational hypertension indicates that additional factors modify the risk of preeclampsia