Abnormal spiral arteries modification in stillbirths: the role of maternal prepregnancy body mass index

Aim: To evaluate the prevalence of abnormal spiral arteries modification (ASAM) in stillbirths and its anatomo-clinical correlations. Methods: Two-hundred and three placentas of stillbirth >= 20 weeks of gestation were analyzed. Results: ASAM was present in 69/203 cases (33.9%). The only maternal characteristic that significantly differed in ASAM versus normal spiral arteries modification (NSAM) cases was the prepregnancy body mass index (BMI) (25.9 +/- 6.1 and 23.1 +/- 4.2 kg/m(2), respectively) with 15.9% of obesity in ASAM mothers versus 5.2% in NSAM (p = 0.02). Conclusion: Given the association between obesity and adverse pregnancy outcome, our data suggest that counselling obese women to lose weight before pregnancy becomes increasingly imperative.