Chorionic vascular “fit” in the human placenta: Relationship to fetoplacental outcomes

Abstract

Background Novel measures of the chorionic plate and vessels are used to test the hypothesis that variation in placental structure is correlated with reduced birth weight (BW) independent of placental weight (PW), suggesting functionally compromised placentas. Methods 917 mothers recruited to the Pregnancy, Infection and Nutrition Study delivering singleton live born infants at >30 gestational weeks had placentas collected, digitally photographed and weighed prior to formalin fixation. Beta (β) was calculated as ln(PW)/ln(BW). Chorionic disk perimeter was traced and chorionic surface shape (CS) area was calculated. The sites at which chorionic vessels dived beneath the chorionic surface were marked to calculate the chorionic surface vessel (CV) area. The centroids of shapes, the distance between centroids and other measures of shape irregularities were calculated. Principal components analysis (PCA) created three independent factors to explore relations to BW, GA, trimmed PW, and β with p<0.05 considered significant. Results Variables related to disk size (CS area, perimeter) were correlated with BW, GA, trimmed PW and β. “Fit” (the ratio of CV area to CS area), measures of shape irregularities, and the distance between the cord insertion and the centroids of surface and vascular areas were also correlated with one or more of the clinical variables. PCA yielded three factors that had independent effects on β (each p<0.0001). Addition of GA did not alter the factors’ association with β. Conclusions Measures of CS and CV account for variation in placental efficiency defined by β, independent of GA. Macroscopic placenta measurements can identify suboptimal placental development.

How often is the placenta included in human pregnancy research? A rapid systematic review of the literature

“…Similarly, Hauspurg et al found that the presence of placental maternal vascular malperfusion in healthy pregnancies was associated with increased risk of adverse outcomes in later pregnancies 18 . In a cohort study of over 900 pregnant women, Salafia et al found that placental disk size, including chorionic surface shape area and perimeter, was correlated with infant birth weight and gestational age at delivery 19 .…”

Advances in Human Placental Biomechanics

“…A recent study of 2120 women found a relationship between placental surface area and weight, with uterine and umbilical blood flows, both of which are associated with fetal growth rate [ 8 ]. Another study of 916 women found correlations between the surface area of the chorionic plate and its perimeter with birth weight [ 9 ], suggesting that these comparatively simple measurements can identify suboptimal placental development. Although umbilical cord insertion is assumed to happen at the centre of the chorionic surface, a recent study found that the cord is actually not centred [ 7 ].…”

Placental Growth and Development Analyzed through 2D and 3D Fractals

“…In contrast to most permanent viscera that have more fixed shapes, the placenta is amoeboid and responds to intrauterine exposures by modifying its gross and microscopic structure and vascularization [16][17][18][19][20][21][22][23][24][25]. Shape variations that mark altered placental vascularization include irregularities of chorionic surface area, shape, thickness, and vascular patterning and cord insertion [26].…”