Microanatomical Alterations of Placenta in Gestational Diabetes Mellitus: Comparative Analysis of Lean and Obese Pregnancies in a Central Indian Cohort

Abstract Background: Gestational diabetes mellitus (GDM) and maternal obesity significantly influence placental structure and function, impacting maternal and fetal outcomes. Although morphological changes in GDM placentas are documented, comparative evaluation of lean and obese GDM subgroups remains limited. The objective of this study was to identify microanatomical alterations and assess the effect of glycemic control in placentas of women with GDM versus normoglycemia, with emphasis on differences between lean and obese GDM subgroups. Methodology: This observational study was conducted at tertiary care centers in the Central Vidarbha region, India. The pregnant women in their first trimester were enrolled and grouped as Non-GDM (body mass index [BMI] ≤22.9, n = 40), lean GDM (BMI ≤22.9, n = 40), and obese GDM (BMI ≥23, n = 40). GDM diagnosis was made using a 75g oral glucose tolerance test according to Indian national guidelines. Comprehensive demographic and detailed histopathological analyses were performed on placentas. Statistical analysis included one-way analysis of variance, Chi-square tests, and multivariate logistic regression.