E M Macdonald1, R Natale2, T R H Regnault3, J J Koval4, M K Campbell5. 1. Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Canada N6A 5C1. Electronic address: emacd02@gmail.com. 2. Department of Obstetrics and Gynecology, The University of Western Ontario, London, Canada N6A 5C1; Department of Paediatrics, The University of Western Ontario, London, Canada N6A 5C1. Electronic address: Renato.Natale@lhsc.on.ca. 3. Department of Obstetrics and Gynecology, The University of Western Ontario, London, Canada N6A 5C1; Department of Physiology and Pharmacology, The University of Western Ontario, London, Canada N6A 5C1; The Children's Health Research Institute, London, Canada N6A 5C1. Electronic address: tim.regnault@uwo.ca. 4. Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Canada N6A 5C1. Electronic address: jkoval@uwo.ca. 5. Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Canada N6A 5C1; Department of Obstetrics and Gynecology, The University of Western Ontario, London, Canada N6A 5C1; Department of Paediatrics, The University of Western Ontario, London, Canada N6A 5C1; The Children's Health Research Institute, London, Canada N6A 5C1. Electronic address: karen.campbell@schulich.uwo.ca.
Abstract
INTRODUCTION: To elucidate how obstetric conditions are associated with atypical placental weight ratios (PWR)s in infants born: (a) ≥37 weeks gestation; (b) at ≥33 but <37 weeks gestation; and (c) <33 weeks gestation. METHODS: The study included all in-hospital singleton births in London, Ontario between June 1, 2006 and March 31, 2011. PWR was assessed as <10th or >90th percentile by gestational age-specific local population standards. Multivariable analysis was carried out using multinomial logistic regression with blockwise variable entry in order of temporality. RESULTS: Baseline factors and maternal obstetric conditions associated with PWR <10th percentile were: increasing maternal height, overweight and obese body mass indexes (BMI), large for gestational age infants, smoking, and gestational diabetes. Obstetric factors associated with PWR >90th percentile were: underweight, overweight and obese BMIs, smoking, preeclampsia, placenta previa, and placental abruption. In particular, indicators of hypoxia and altered placental function were generally associated with elevated PWR at all gestations. DISCUSSION: An association between obstetric conditions associated with fetal hypoxia and PWR ≥90th percentile was illustrated. CONCLUSIONS: The multivariable findings suggest that the PWR is similarly increased regardless of the etiology of the hypoxia.
INTRODUCTION: To elucidate how obstetric conditions are associated with atypical placental weight ratios (PWR)s in infants born: (a) ≥37 weeks gestation; (b) at ≥33 but <37 weeks gestation; and (c) <33 weeks gestation. METHODS: The study included all in-hospital singleton births in London, Ontario between June 1, 2006 and March 31, 2011. PWR was assessed as <10th or >90th percentile by gestational age-specific local population standards. Multivariable analysis was carried out using multinomial logistic regression with blockwise variable entry in order of temporality. RESULTS: Baseline factors and maternal obstetric conditions associated with PWR <10th percentile were: increasing maternal height, overweight and obese body mass indexes (BMI), large for gestational age infants, smoking, and gestational diabetes. Obstetric factors associated with PWR >90th percentile were: underweight, overweight and obese BMIs, smoking, preeclampsia, placenta previa, and placental abruption. In particular, indicators of hypoxia and altered placental function were generally associated with elevated PWR at all gestations. DISCUSSION: An association between obstetric conditions associated with fetal hypoxia and PWR ≥90th percentile was illustrated. CONCLUSIONS: The multivariable findings suggest that the PWR is similarly increased regardless of the etiology of the hypoxia.
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