[Correlation of placental villous immaturity and dysmaturity with clinical control of maternal diabetes].

Strict clinical management of a diabetic mother who is pregnant reduces the risk of neonatal complications. It also reduces the frequency of fetal macrosomia. Diabetic mothers have a heavier placenta than mothers who are not diabetic. Light microscopic placental changes associated with diabetes include villous immaturity and dysmaturity. We have examined the placentas of 27 diabetic mothers whose maternal hemoglobin A1c (HbA1C) levels were measured throughout pregnancy. None of these placentas had a trimmed weight in excess of 600 grams. Eighteen of 27 specimens had immature villi. Four had dysmature villi. Three placentas had fibromuscular sclerosis within the villi. Five had cholangiosis and there was one cholangioma. Villous immaturity was present in 16 of 18 mothers whose HbA1C was more than 5.6% of the total hemoglobin. We found villous immaturity in 2 of 5, within 5.1-5.5% HbA1C. There was no villous immaturity in four cases whose HbA1C was less than 5.0% total hemoglobin. Our findings indicate that maternal hyperglycemia during pregnancy is associated with placental immaturity and dysmaturity.