Gross Placental Structure in a Low-Risk Population of Singleton, Term, First-Born Infants

Coall, David A.; Charles, Adrian; Salafia, Carolyn M.

doi:10.2350/08-02-0413.1

Cited by 20 publications

(18 citation statements)

References 73 publications

(108 reference statements)

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“…Surprisingly, our results showed a higher R-squared for prediction of BW compared with other studies, although it was methodologically different. [26][27][28] After adjustment for maternal characteristics, GA and infant gender, 77% of BW variances were accounted for, suggesting 'partial mediation' of their effects on BW by the feature of the four placental measures. ►Table 2 shows that only placental weight and largest diameter retained an independent effect on BW after adjustment for mother and infant conditions, in consonance with another study.…”

Section: Discussionmentioning

confidence: 99%

Placental Growth Measures in Relation to Birth Weight in a Latin American Population

Grandi

Veiga

Mazzitelli

et al. 2016

Rev Bras Ginecol Obstet

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Introduction The placenta, translates how the fetus experiences the maternal environment and is a principal influence on birth weight (BW). Objective To explore the relationship between placental growth measures (PGMs) and BW in a public maternity hospital. Methods Observational retrospective study of 870 singleton live born infants at Hospital Maternidad Sardá, Universidad de Buenos Aires, Argentina, between January 2011 and August 2012 with complete data of PGMs. Details of history, clinical and obstetrical maternal data, labor and delivery and neonatal outcome data, including placental measures derived from the records, were evaluated. The following manual measurements of the placenta according to standard methods were performed: placental weight (PW, g), larger and smaller diameters (cm), eccentricity, width (cm), shape, area (cm(2)), BW/PW ratio (BPR) and PW/BW ratio (PBR), and efficiency. Associations between BW and PGMs were examined using multiple linear regression. Results Birth weight was correlated with placental weight (R(2) = 0.49, p < 0.001), whereas gestational age was moderately correlated with placental weight (R(2) = 0.64, p < 0.001). By gestational age, there was a positive trend for PW and BPR, but an inverse relationship with PBR (p < 0.001). Placental weight alone accounted for 49% of birth weight variability (p < 0,001), whereas all PGMs accounted for 52% (p < 0,001). Combined, PGMs, maternal characteristics (parity, pre-eclampsia, tobacco use), gestational age and gender explained 77.8% of BW variations (p < 0,001). Among preterm births, 59% of BW variances were accounted for by PGMs, compared with 44% at term. All placental measures except BPR were consistently higher in females than in males, which was also not significant. Indices of placental efficiency showed weakly clinical relevance. Conclusions Reliable measures of placental growth estimate 53.6% of BW variances and project this outcome to a greater degree in preterm births than at term. These findings would contribute to the understanding of the maternal-placental programming of chronic diseases.

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Section: Discussionmentioning

confidence: 99%

Placental Growth Measures in Relation to Birth Weight in a Latin American Population

Grandi

Veiga

Mazzitelli

et al. 2016

Rev Bras Ginecol Obstet

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“…observed that smoking during pregnancy reduced birth weight and increased the eccentricity of umbilical cord insertion. [13]…”

Section: Discussionmentioning

confidence: 99%

Histopathological study of placentae in low birth weight babies in India

Nigam¹,

Misra²,

Singh³

et al. 2014

Ann Med Health Sci Res

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Background:The antenatal health-care given to pregnant women has great influence on the rates of perinatal death and morbidity. Amongst the different causes of perinatal mortality, low birth weight (LBW) is the single most significant factor therefore placenta from all the LBW babies (LBWB) should be examined routinely to find out the likely cause.Aims:The aims of this study were to assess the pathological changes in the placenta in association with LBWB.Materials and Methods:This is a Case control study performed at Medical College Allahabad,(MLN) India. In this study, 90 placentae were included. 30 placentae from full-term vaginally delivered babies, weighing more than 2500 g were included as the control group. 60 placentae belonged to babies whose birth weight was less than 2500 g (LBW). Weight of the baby was taken within the 1st h of birth and Apgar score was noted. Gross and microscopic examination of placentae was done. Statistical correlation of was carried out between them by using SPSS 18 version. Chi-square test with or without yate's correction was used as and when required. P < 0.05 was taken as critical level of significance.Results:Placenta was circum-marginal in both groups. Attachment of cord was mainly central in the control group 90% (27/30), whereas eccentric attachment was prominent in patient group 66.67% (40/60). The difference was statistically significant (P < 0.001). Calcification and sub-chorionic fibrin deposition was seen in significantly higher numbers of placentae from patients than controls (P < 0.01) infarction and meconium staining were seen in placentae from patients only. Histologically placental ischemia, infarction and calcification were seen in significantly higher number of patients (P < 0.001, P < 0.001 and < 0.01 respectively). Fibrinoid necrosis, stromal fibrosis, placental dysmaturity and obstructive vasculopathy were seen in placentae from patients only.Conclusion:Placental pathology among LBW infants was high in comparison to control group. The findings suggest that chronic ischemia and associated secondary changes probably lead to improper perfusion and LBWB.

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“…Unfortunately, there is no specific marker that reflects overall placental transport function. However, placental weight is related to total placental surface area, and given a reasonably constant density of transporters, also to total transport capacity [42]. Accordingly, placental weight may in normal pregnancies be used as a substitute for functional capacity.…”

Section: Discussionmentioning

confidence: 99%

Newborn Body Fat: Associations with Maternal Metabolic State and Placental Size

et al. 2013

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BackgroundNeonatal body composition has implications for the health of the newborn both in short and long term perspective. The objective of the current study was first to explore the association between maternal BMI and metabolic parameters associated with BMI and neonatal percentage body fat and to determine to which extent any associations were modified if adjusting for placental weight. Secondly, we examined the relations between maternal metabolic parameters associated with BMI and placental weight.MethodsThe present work was performed in a subcohort (n = 207) of the STORK study, an observational, prospective study on the determinants of fetal growth and birthweight in healthy pregnancies at Oslo University Hospital, Norway. Fasting glucose, insulin, triglycerides, free fatty acids, HDL- and total cholesterol were measured at week 30–32. Newborn body composition was determined by Dual-Energy X-Ray Absorptiometry (DXA). Placenta was weighed at birth. Linear regression models were used with newborn fat percentage and placental weight as main outcomes.ResultsMaternal BMI, fasting glucose and gestational age were independently associated with neonatal fat percentage. However, if placental weight was introduced as a covariate, only placental weight and gestational age remained significant. In the univariate model, the determinants of placenta weight included BMI, insulin, triglycerides, total- and HDL-cholesterol (negatively), gestational weight gain and parity. In the multivariable model, BMI, total cholesterol HDL-cholesterol, gestational weight gain and parity remained independent covariates.ConclusionMaternal BMI and fasting glucose were independently associated with newborn percentage fat. This effect disappeared by introducing placental weight as a covariate. Several metabolic factors associated with maternal BMI were associated with placental weight, but not with neonatal body fat. Our findings are consistent with a concept that the effects of maternal BMI and a number of BMI-related metabolic factors on fetal fat accretion to a significant extent act by modifying placental weight.

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Gross Placental Structure in a Low-Risk Population of Singleton, Term, First-Born Infants

Cited by 20 publications

References 73 publications

Placental Growth Measures in Relation to Birth Weight in a Latin American Population

Placental Growth Measures in Relation to Birth Weight in a Latin American Population

Histopathological study of placentae in low birth weight babies in India

Newborn Body Fat: Associations with Maternal Metabolic State and Placental Size

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