Association of Placental Histology with the Pulsatility Index of Fetal and Uteroplacental Vessels during Pregnancy and with Birthweight Z-Score.
Placental histology
birthweight z-score
fetal vascular malperfusion
maternal vascular malperfusion
multivessel Doppler assessment
placental abruption
Journal
Medical research archives
ISSN: 2375-1916
Titre abrégé: Med Res Arch
Pays: United States
ID NLM: 101668511
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
medline:
15
9
2023
pubmed:
15
9
2023
entrez:
15
9
2023
Statut:
ppublish
Résumé
To compare macro- and microscopic features of the placenta with the pulsatility index (PI) of the uterine (UtA), umbilical (UA) and middle cerebral arteries at 20-24- and 34-38-weeks' gestation, and with birthweight z-scores (BWZS). Recruitment for the Safe Passage Study, which investigated the association of alcohol and tobacco use with stillbirth and sudden infant death syndrome, occurred from August 2007 to January 2015 at community clinics in Cape Town, South Africa. The population represents a predominantly homogenous population of pregnant women from a low socioeconomic residential area. This study is a further analysis of the data of the Safe Passage Study. It consists of 1205 singleton pregnancies for which placental histology was available, of whom 1035 had a known BWZS and 1022 and 979 had fetoplacental Doppler examinations performed at Tygerberg Academic Hospital at 20-24 and 34-38 weeks respectively. Features of the placenta were assessed according to international norms. Significantly higher ORs for the presence of individual and combined features of maternal vascular malperfusion (MVM) were found with lower BWZS and higher UtA PI values, more consistently than with higher UA PI values. Strongest associations were for a small placenta for gestational age (UtA OR 4.86 at 20-24 and 5.92 at 34-38 weeks; UA OR 5.33 at 20-24 and 27.01 at 34-38 weeks; low BWZS OR 0.31), for accelerated maturation (UtA OR 11.68 at 20-24 weeks and 18.46 at 34-38 weeks; low BWZS 0.61), for macroscopic infarction (UtA OR 6.08 at 20-24 weeks; UA OR 17.02 at 34-38 weeks; low BWZS OR 0.62) and for microscopic infarction (UtA OR 6.84 at 20-24 and 10.9 at 34-38 weeks; low BWZS OR 0.62). There is considerable variability in the associations between individual features of MVM and increased UtA or UA PI and low BWZS. Although all MVM features currently carry equal weight in defining the condition of MVM, our data suggest that some should carry more weight than others. Macroscopic examination of the placenta may be helpful in identifying placental insufficiency as a small placenta for gestational age and macroscopic infarction were the features most strongly associated with outcomes.
Identifiants
pubmed: 37712063
doi: 10.18103/mra.v11i8.4238
pmc: PMC10501112
mid: NIHMS1924385
doi:
Types de publication
Journal Article
Langues
eng
Subventions
Organisme : NIAAA NIH HHS
ID : U01 AA016501
Pays : United States
Organisme : NICHD NIH HHS
ID : U01 HD045935
Pays : United States
Organisme : NICHD NIH HHS
ID : U01 HD055154
Pays : United States
Organisme : NICHD NIH HHS
ID : U01 HD055155
Pays : United States
Déclaration de conflit d'intérêts
Disclosure of interests We have no interests to declare.
Références
Semin Fetal Neonatal Med. 2018 Apr;23(2):119-125
pubmed: 29221766
Paediatr Perinat Epidemiol. 2014 Sep;28(5):455-65
pubmed: 25131605
Eur J Obstet Gynecol Reprod Biol. 2011 Nov;159(1):77-82
pubmed: 21839575
Placenta. 2022 Nov;129:77-83
pubmed: 36257090
Placenta. 2021 Feb;105:78-84
pubmed: 33556717
JAMA Netw Open. 2021 Aug 2;4(8):e2121726
pubmed: 34424306
Obstet Gynecol. 1989 Mar;73(3 Pt 1):379-82
pubmed: 2644597
Acta Obstet Gynecol Scand. 2016 Feb;95(2):135-43
pubmed: 26577070
Lancet Diabetes Endocrinol. 2014 Oct;2(10):781-92
pubmed: 25009082
Ultrasound Obstet Gynecol. 2014 May;43(5):500-7
pubmed: 24339044
Ultrasound Obstet Gynecol. 2022 Jul;60(1):28-41
pubmed: 34806234
Eur J Obstet Gynecol Reprod Biol. 2020 Oct;253:95-102
pubmed: 32862031
Ultrasound Obstet Gynecol. 2019 Nov;54(5):609-616
pubmed: 31115105
Placenta. 2009 Aug;30(8):700-4
pubmed: 19535137
Semin Perinatol. 2015 Feb;39(1):2-8
pubmed: 25455619
Eur J Obstet Gynecol Reprod Biol. 2000 Sep;92(1):35-43
pubmed: 10986432
Acta Obstet Gynecol Scand. 2019 Dec;98(12):1585-1594
pubmed: 31370094
J Perinat Med. 2019 Feb 25;47(2):222-240
pubmed: 30231013
Eur J Obstet Gynecol Reprod Biol. 2008 Jan;136(1):9-15
pubmed: 17683846
J Obstet Gynaecol. 2016;36(2):192-5
pubmed: 26431437
Birth Defects Res. 2017 Oct 16;109(17):1345-1357
pubmed: 29105379
Ultrasound Obstet Gynecol. 2019 Jul;54(1):58-63
pubmed: 30084237
Ultrasound Obstet Gynecol. 2015 Oct;46(4):398-404
pubmed: 25683973
BJOG. 2019 Aug;126(9):1157-1167
pubmed: 30576053
Placenta. 2014 Aug;35(8):552-62
pubmed: 24953162
J Perinat Med. 1996;24(4):327-34
pubmed: 8880629
S Afr Med J. 2020 Oct 28;110(11):1100-1104
pubmed: 33403986
J Perinat Med. 2021 Jan 13;49(4):412-430
pubmed: 33554577
Pediatr Pathol Lab Med. 1996 Nov-Dec;16(6):901-7
pubmed: 9025888
Arch Pathol Lab Med. 2022 Mar 1;146(3):372-378
pubmed: 34252177
Am J Obstet Gynecol. 2011 Sep;205(3):246.e1-7
pubmed: 21803321
Pediatr Dev Pathol. 2017 Mar-Apr;20(2):120-132
pubmed: 28326963
Semin Perinatol. 2014 Apr;38(3):131-2
pubmed: 24836823
J Perinat Med. 2021 Sep 30;50(6):753-762
pubmed: 34587673
Eur J Obstet Gynecol Reprod Biol. 2018 Mar;222:52-56
pubmed: 29408751
Arch Pathol Lab Med. 2016 Jul;140(7):698-713
pubmed: 27223167
Arch Gynecol Obstet. 2019 Dec;300(6):1583-1589
pubmed: 31667612
In Vivo. 2019 Nov-Dec;33(6):2199-2204
pubmed: 31662556
Gac Med Mex. 2022;158(1):48-54
pubmed: 35404926
Ultrasound Obstet Gynecol. 2013 Feb;41(2):233-39
pubmed: 23371348
Placenta. 2022 Mar 24;120:40-48
pubmed: 35189547
Int J Gynaecol Obstet. 2004 Jan;84(1):23-31
pubmed: 14698826
APMIS. 2018 Jul;126(7):551-560
pubmed: 30129127
Am J Epidemiol. 2001 Apr 15;153(8):771-8
pubmed: 11296149
Ultrasound Obstet Gynecol. 2010 Aug;36(2):178-85
pubmed: 20503251