Evidence of maternal vascular malperfusion in placentas of women with congenital heart disease

Rodríguez‐Soto, Ana E.; Pham, D H; Tran, Tracy; Meads, Morgan; Stanley, Valentina; Melber, Dora J.; Lamale‐Smith, Leah; Zhang-Rutledge, Kathy; Rakow‐Penner, Rebecca; Alshawabkeh, Laith; Parast, Mana M.; Contijoch, Francisco

doi:10.1016/j.placenta.2021.12.016

Cited by 2 publications

(1 citation statement)

References 28 publications

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“…For adjudication of hypertensive disease(s) and diabetes, relevant clinical and laboratory data were entered into the database and subsequently reviewed by two practicing obstetricians, and diagnoses adjudicated according to standards de ned by the American College of Obstetricians and Gynecologists (ACOG). (24) Neonatal Characteristic and Outcomes Infant sex, birthweight (grams), and Apgar scores at 1 and 5 minutes were extracted from mothers' delivery records. Birthweight percentile was calculated based on Hadlock formula adjusted for gestational age.…”

Section: Maternal Characteristics and Pregnancy Outcomesmentioning

confidence: 99%

Placental pathology and fetal growth outcomes in pregnancies complicated by maternal obesity

Hietalati,

Pham,

Arora

et al. 2024

Int J Obes

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Background:The rising prevalence of maternal obesity presents a signi cant health concern because of the possible implications for obstetric complications and neonatal outcomes. Understanding the impact of obesity on placental structure and function as well as fetal growth and infant outcomes is important to improve the care of these potentially high-risk pregnancies. This study aimed to determine the effect of elevated maternal BMI on histopathologic patterns of placental injury and its consequences on fetal growth. Methods:Data were collected from an ongoing cohort of maternal-infant dyads in the UCSD Obstetric Registry spanning 2011-2020. Maternal characteristics, including BMI, hypertensive disease and diabetes, placental gross and histopathology, and infant characteristics, including sex and birthweight, were recorded and analyzed. ANOVA, chi-square tests, and log-binomial and linear regression models adjusted for relevant confounders were employed to determine associations between maternal BMI, speci c patterns of placental injury, and infant birthweight percentiles. Results:Among 1366 maternal-infant dyads, placentas from overweight and obese mothers were heavier and demonstrated higher adjusted relative risks of chronic villitis (CV), decidual vasculopathy, intervillous thrombosis, and normoblastemia. Placental e ciency, determined by fetal-placental weight ratio, was decreased with increasing BMI. Maternal obesity was associated with higher rates of preterm birth and higher birthweight percentiles. Multiple placental lesions, including maternal (MVM) and fetal vascular malperfusion (FVM), exhibited signi cant effects on birthweight percentiles; however, only MVM showed a differential effect based on maternal obesity. Conclusions:Maternal obesity is associated with increased rates of placental patterns of injury, decreased placental e ciency, and increased birthweight percentiles. While placental lesions, such as CV, have the potential to negatively impact fetal growth, the resulting birthweight percentiles demonstrate a more complex relationship between maternal obesity and fetal growth, that likely involves placental and fetal adaptation to the altered in utero environment.

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Section: Maternal Characteristics and Pregnancy Outcomesmentioning

confidence: 99%

Placental pathology and fetal growth outcomes in pregnancies complicated by maternal obesity

Hietalati,

Pham,

Arora

et al. 2024

Int J Obes

Self Cite

View full text Add to dashboard Cite

show abstract

Placental Pathology and Fetal Growth Outcomes in Pregnancies Complicated by Maternal Obesity

Jacobs,

Hietalati,

Pham

et al. 2023

Preprint

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Background: The rising prevalence of maternal obesity presents a significant health concern because of the possible implications for obstetric complications and neonatal outcomes. Understanding the impact of obesity on placental structure and function as well as fetal growth and infant outcomes is important to improve the care of these potentially high-risk pregnancies. This study aimed to determine the effect of elevated maternal BMI on histopathologic patterns of placental injury and its consequences on fetal growth. Methods: Data were collected from an ongoing cohort of maternal-infant dyads in the UCSD Obstetric Registry spanning 2011–2020. Maternal characteristics, including BMI, hypertensive disease and diabetes, placental gross and histopathology, and infant characteristics, including sex and birthweight, were recorded and analyzed. ANOVA, chi-square tests, and log-binomial and linear regression models adjusted for relevant confounders were employed to determine associations between maternal BMI, specific patterns of placental injury, and infant birthweight percentiles. Results: Among 1366 maternal-infant dyads, placentas from overweight and obese mothers were heavier and demonstrated higher adjusted relative risks of chronic villitis (CV), decidual vasculopathy, intervillous thrombosis, and normoblastemia. Placental efficiency, determined by fetal-placental weight ratio, was decreased with increasing BMI. Maternal obesity was associated with higher rates of preterm birth and higher birthweight percentiles. Multiple placental lesions, including maternal (MVM) and fetal vascular malperfusion (FVM), exhibited significant effects on birthweight percentiles; however, only MVM showed a differential effect based on maternal obesity. Conclusions: Maternal obesity is associated with increased rates of placental patterns of injury, decreased placental efficiency, and increased birthweight percentiles. While placental lesions, such as CV, have the potential to negatively impact fetal growth, the resulting birthweight percentiles demonstrate a more complex relationship between maternal obesity and fetal growth, that likely involves placental and fetal adaptation to the altered in utero environment.

show abstract

Evidence of maternal vascular malperfusion in placentas of women with congenital heart disease

Cited by 2 publications

References 28 publications

Placental pathology and fetal growth outcomes in pregnancies complicated by maternal obesity

Placental pathology and fetal growth outcomes in pregnancies complicated by maternal obesity

Placental Pathology and Fetal Growth Outcomes in Pregnancies Complicated by Maternal Obesity

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