Comparison of Wharton’s Jelly Area in The Umbilical Cord Between Normal Pregnancies and Those with Preeclampsia in Relation to Birth Weight at Adam Malik Hospital and Hospitals within the University of North Sumatra Network

Abstract

Preeclampsia is one of the major complications of pregnancy that contributes significantly to maternal and fetal morbidity and mortality worldwide. This condition is associated with impaired placental function and fetal growth abnormalities, although the mechanisms underlying fetal growth restriction remain incompletely understood. Wharton’s jelly, an extracellular matrix component of the umbilical cord, plays an important role in maintaining umbilical blood flow and protecting fetal circulation. This study aimed to compare the area of Wharton’s jelly between normal pregnancies and preeclampsia pregnancies and to evaluate its relationship with infant birth weight. A comparative cross-sectional study was conducted involving 50 postpartum mothers, consisting of 25 preeclampsia cases and 25 normotensive pregnancies, at Adam Malik Hospital Medan, Prof. CPL USU Hospital, and Sundari Hospital Medan. Samples were collected using consecutive sampling, and measurements of umbilical cord morphology, Wharton’s jelly area, placental characteristics, and infant birth weight were analyzed using appropriate statistical tests. The results showed that the Wharton’s jelly area was significantly smaller in the preeclampsia group compared with the normotensive group (p < 0.001). Infants born to mothers with preeclampsia also had significantly lower birth weights (p = 0.045). Furthermore, Wharton’s jelly area was positively correlated with birth weight in the normotensive group (p = 0.014; r = 0.486), but no significant correlation was observed in the preeclampsia group. In conclusion, reduced Wharton’s jelly area is associated with preeclampsia and may contribute to differences in fetal growth outcomes. Further studies with larger populations and molecular approaches are needed to clarify its potential as a predictive biomarker for adverse pregnancy outcomes.