Comparison of Placental Structure in Pregnant Women With Undernutrition and Those With Normal Nutrition Delivered at Bungoma County Referral Hospital Between January 2018 and December 2019

Abstract

Background: The prevalence of maternal, fetal and newborn morbidity and mortality associated with undernutrition is high in the lower and middle income countries. A significant number of the pregnant population in Africa is suffering from malnutrition, above 10% of the standard acceptable malnutrition rate. Pregnancy solely depends on the health and nutrition status of the pregnant woman. Poor access to food due to poverty, poor infrastructure and political instability leads pregnant women to poor health and associated complications such as foetal growth restriction due to the associated factors such as fetal anaemia. Even though the relation between undernutrition in the pregnant woman and developing fetus has been extensively correlated, its effect on the placenta has not been widely studied, more so in our setting. Determining the effect of undernutrition on the placenta requires an extensive study to improve both the pregnant woman’s health and health of the developing fetus. Objective: To compare placental structure in pregnant women with undernutrition and those with normal nutrition who were delivered at Bungoma county Referral hospital. Methodology: This was a comparative cross-sectional laboratory-based study. The study was done at the Basic, Clinical and Translational (BCT) research laboratory located in the Department of Human Anatomy, University of Nairobi. We utilized placenta samples from the placenta biorepository at the Basic, Clinical and Translational (BCT) research laboratory located in the Department of Human Anatomy, University of Nairobi. A gross appearance including obvious colour change, shape, diameter, weight, umbilical cord insertion thrombosis and infarction of the placentae of women who meet the inclusion criteria were noted. Sectioned blocks of placentae collected from 6 different regions in the placentae were analysed histologically for changes in the structural appearance of terminal villous and basal plate. A morphometric analysis of the placental terminal villi was done, and the results compared to findings in normal placentae...