Histological Changes of Placenta in Anaemic Post Gravid Women of Abbottabad: A Cross-Sectional Study

Abstract

Background: Maternal anemia remains one of the most common nutritional and hematological disorders affecting pregnancy outcomes worldwide. It is known to impair placental development and function, leading to structural and histological alterations that compromise fetal growth and well-being. This study aimed to assess the histological changes in placentas of anaemic post-gravid women and compare them with non-anaemic controls.

Methods: A cross-sectional study was conducted in the Department of Pathology, Ayub Medical Complex, Abbottabad, Pakistan, over 12 months (February 2024–January 2025). A total of 366 placentas were examined, including 183 from anaemic and 183 from non-anaemic post-gravid women. Placental samples were collected immediately after delivery, processed, and stained with hematoxylin and eosin, and selected cases with PAS and Masson’s trichrome stains. Gross and microscopic parameters were analyzed, including placental weight, diameter, thickness, syncytial knot formation, villous crowding, cytotrophoblastic proliferation, stromal fibrosis, and basement membrane thickening. Statistical analysis was performed using SPSS v26.0, with p < 0.05 considered significant.

Results: Anaemic placentas showed significantly reduced weight (430.5 ± 54.2 g), diameter (17.6 ± 1.3 cm), and thickness (1.8 ± 0.3 cm) compared to controls (p < 0.001). Histologically, anaemic placentas exhibited increased syncytial knots, villous crowding, cytotrophoblastic proliferation, fibrinoid necrosis, stromal fibrosis, and basement membrane thickening, all showing strong negative correlations with maternal hemoglobin levels (p < 0.05).

Conclusion: Maternal anemia induces marked histopathological alterations in the placenta, reflecting adaptive and degenerative responses to chronic hypoxia that may compromise fetal growth and pregnancy outcomes.