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https://doi.org/10.14300/mnnc.2026.00005

Immune and pathomorphological markers of low-level placental inflammation in preterm women with obesity

[Obstetrios and gynecology]
Elena Kuzmina; Alexey Michaelis; Andrey Balabekov; Karina Aleksandrovna Papikova; Kristina Kuyumcheva; Eleonora Ryzhkova;

The aim of the study was to evaluate the immune profile in early pregnancy and placental morphotypes in obese and preterm women. The study included 94 women with impaired fat metabolism whose pregnancies ended in premature birth at 28–36 weeks. At 8–10 weeks of gestation, serum levels of proinflammatory cytokines (TNF-α, IFN-γ, IL-1β, IL-6, IL-8) and regulatory IL-4 were determined by ELISA. After delivery, a comprehensive pathomorphological examination of the placentas was performed, including morphometry and histological analysis. Women with obesity showed impaired immuno-metabolic homeostasis with a predominance of Th-1 over Th-2 immunity: significant activation of proinflammatory cytokines and acompensatory increase in IL-4. It was shown that the severity of pathomorphological changes in the placenta (circulatory,
involutive-dystrophic, inflammatory) significantly increased with increasing body mass index. Among the features of placentas in obesity, destructive changes of an inflammatory nature prevailed, while in overweight there was the morphological picture corresponding to the stage of subcompensation of placental insufficiency. Cytokine imbalance in early pregnancy in women with obesity, characterized by a systemic pro-inflammatory shift, is associated with specific pathomorphological changes in the placenta and reflects the degree of placental dysfunction against the background of metainflammation. The identified immune and morphological markers can serve as predictors of preterm birth in this category of patients.

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Keywords: obesity, metainflammation, cytokine profile, immuno-metabolic homeostasis, humoral immunity, placental pathomorphology