Placental Pathologic Changes Associated with Fetal Growth Restriction and Consequent Neonatal Outcomes

Im, Do Hwa; Kim, Young Nam; Cho, Hwa Jin; Park, Yong‐Hee; Kim, Da Hyun; Byun, Jung Mi; Jeong, Dae Hoon; Lee, Kyung Bok; Sung, Moon Su

doi:10.1080/15513815.2020.1723147

Cited by 6 publications

(4 citation statements)

References 33 publications

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“…Compared to normal pregnancies, MVM lesions are associated with increased risks of SGA, FGR, abnormal uterine arteries Doppler waveforms, and adverse pregnancy outcome [28]. Although placental MVM features are very commonly reported in pregnancies with FGR, data relating MVM severity with neonatal outcome in FGR pregnancies or clinical and sonographic markers of disease severity are mainly based on retrospective data, or case-control studies [7, 8, 29]. In a small cohort study including both early- and late-onset FGR, we found that abnormal UA Doppler >95th percentile was significantly correlated with MVM rather than FVM lesions [30].…”

Section: Discussionmentioning

confidence: 99%

“…Pregnancies complicated by fetal growth restriction (FGR) are commonly characterized by placental pathologic elementary lesions, grouped according to topography (maternal or fetal side of the placenta), pathophysiology of FGR and/or preeclampsia (developmental or malperfusion lesions) and/or loss of placental integrity [1-3]. Previous studies have analysed maternal and neonatal clinical correlates of placental maternal (MVM) or fetal (FVM) vascular malperfusion, but they are mainly based on retrospective analysis of premature deliveries, with little or no information regarding the association between placental histopathologic features and Doppler evaluation of fetoplacental circulation [4-7].…”

Section: Introductionmentioning

confidence: 99%

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Clinical Correlates of Placental Pathologic Features in Early-Onset Fetal Growth Restriction

et al. 2022

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Introdcution: The purpose of this study was to evaluate the association between placental pathologic features of maternal (MVM) or fetal (FVM) vascular malperfusion and clinical characteristics, sonographic findings and neonatal outcome in a cohort of pregnancies complicated by early-onset (diagnosed before 32 weeks of gestational age) fetal growth restriction (FGR). Methods: A prospective cohort study included 250 singleton early-onset FGR pregnancies diagnosed, followed up and delivered at a single Centre. Elementary placental pathologic lesions were classified according to standard recommendations. Logistic regression and Cox analysis were used to evaluate outcomes adjusting for confounders. Results: Overall features of severe placental MVM and FVM were observed in 29.6% (74/250) and 12.8% (32/250) of the subjects, respectively. Severe placental MVM lesions were more common among subjects with umbilical artery (UA) Doppler Pulsatility Index > 95th than ≤ 95th percentile (50/120 as opposed to 24/130, Adj OR= 3, 95% CI = 1.6-5.4) and CerebroPlacental Ratio (CPR) < 5th than ≥5th percentile (48/115 as opposed to 26/135, Adj OR= 2.7, 95% CI = 1.5-4.9). Mean time from FGR diagnosis to delivery was shorter among subjects with severe MVM (25.5 days, 95% CI= 20.6-30.2, Adj. OR = 1.9,95% CI = 1.9,95% CI =1.4-2.5) when compared to both those with mild/moderate MVM (36.5 days (95% CI = 27-.2-45, p=0.04) or no MVM (39.4,95% CI = 35.4-43.4, p<.001). Finally, severe FVM was associated with an increased risk of perinatal/neonatal death or severe brain lesions (9/28 in subjects with perinatal/neonatal death/brain lesions as compared to 23/222 in controls, Adj OR= 3, 95% CI = 1.05-8.6) or severe adverse neonatal outcomes (13/46 in subjects with severe adverse outcome as compared to 19/204 among controls, Adj OR= 3.2, 95% CI =1.2-8.5). Conclusions: In early-onset FGR, placental pathologic features of MVM and FVM are distinct independent predictors of severity of clinical picture, abnormal Doppler markers of placental and fetal circulation and of neonatal outcome, respectively.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical Correlates of Placental Pathologic Features in Early-Onset Fetal Growth Restriction

et al. 2022

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“…There is a substantial body of evidence demonstrating the association between SGA neonates, with birth weights below the 10th percentile, and increased rate of placental maternal and fetal vascular malperfusion lesions. These placental lesions were considered to be the hallmark of placental insufficiency and were also associated with adverse early and late neonatal outcome 13,22 …”

Section: Discussionmentioning

confidence: 99%

“…There are many studies demonstrating the association between placental malperfusion lesions with FGR and adverse neonatal outcome compared to appropriate for gestation age (AGA) neonates. In most of them, growth restriction was defined based on neonatal birth weight below the 10th percentile 10–13 …”

Section: Introductionmentioning

confidence: 99%

Is there an association between isolated sonographic abdominal circumference below the 10th percentile and placental vascular lesions?

Torem

Marom

Gonen

et al. 2022

Intl J Gynecology & Obste

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The most commonly adopted definitions for fetal growth restriction (FGR) are based on sonographic estimated fetal weight below the 10th, 5th, or 3rd percentile for gestational age. Other alternative criteria for the definition of FGR include prenatal diagnosis of abdominal circumference below the 10th, 5th, or 3rd percentile. 1 Notably, there are several studies with conflicting results aiming to determine, in a low-risk population, which of the ultrasound parameters would be the better parameter in predicting neonates with FGR,

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Utility of placental biomarkers and fetoplacental Dopplers in predicting likely placental pathology in early and late fetal growth restriction – A prospective study

Hong,

Crawford,

Daly

et al. 2024

Placenta

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Placental Pathologic Changes Associated with Fetal Growth Restriction and Consequent Neonatal Outcomes

Cited by 6 publications

References 33 publications

Clinical Correlates of Placental Pathologic Features in Early-Onset Fetal Growth Restriction

Clinical Correlates of Placental Pathologic Features in Early-Onset Fetal Growth Restriction

Is there an association between isolated sonographic abdominal circumference below the 10th percentile and placental vascular lesions?

Utility of placental biomarkers and fetoplacental Dopplers in predicting likely placental pathology in early and late fetal growth restriction – A prospective study

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