Michal Levy1, Yossi Mizrachi1, Sophia Leytes1, Eran Weiner1, Jacob Bar1, Letizia Schreiber2, Michal Kovo1. 1. 1 Department of Obstetrics & Gynecology, The Edith Wolfson Medical Center, Holon, Israel, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 2. 2 Department of Pathology, The Edith Wolfson Medical Center, Holon, Israel, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Holon, Israel.
Abstract
OBJECTIVE: To study the role of placental pathology in predicting the recurrence of delivery of small for gestational age (SGA) neonates. METHODS: The medical records and placental pathological reports of normotensive women who gave birth at 24 to 42 weeks to neonates with birth weight (BW) <10th percentile were reviewed. Patients were divided according to their subsequent pregnancy into those who developed or did not develop recurrent SGA (BW < 10th percentile). The clinical and pathological characteristics of the index pregnancies were compared between the groups. A prediction model was generated for SGA recurrence. RESULTS: The recurrent SGA group (n = 67) was characterized by a higher rate of placental weight <10th percentile ( P = .01), and higher neonatal to placental weight ratio ( P = .003), as compared to the nonrecurrent SGA group (n = 99). On multivariate logistic regression analysis, placental maternal and fetal vascular malperfusion lesions and higher neonatal to placental weight ratio were all independently associated with recurrent SGA. Birth weight <3rd percentile was the only clinical variable associated with recurrent SGA. A prediction model for recurrent SGA included the following independent risk factors: BW <3rd percentile, villous lesions of maternal vascular malperfusion, and neonatal to placental weight ratio. CONCLUSION: The presence of placental vascular malperfusion lesions and increased neonatal to placental weight ratio at index pregnancy are associated with recurrent SGA in subsequent pregnancy.
OBJECTIVE: To study the role of placental pathology in predicting the recurrence of delivery of small for gestational age (SGA) neonates. METHODS: The medical records and placental pathological reports of normotensive women who gave birth at 24 to 42 weeks to neonates with birth weight (BW) <10th percentile were reviewed. Patients were divided according to their subsequent pregnancy into those who developed or did not develop recurrent SGA (BW < 10th percentile). The clinical and pathological characteristics of the index pregnancies were compared between the groups. A prediction model was generated for SGA recurrence. RESULTS: The recurrent SGA group (n = 67) was characterized by a higher rate of placental weight <10th percentile ( P = .01), and higher neonatal to placental weight ratio ( P = .003), as compared to the nonrecurrent SGA group (n = 99). On multivariate logistic regression analysis, placental maternal and fetal vascular malperfusion lesions and higher neonatal to placental weight ratio were all independently associated with recurrent SGA. Birth weight <3rd percentile was the only clinical variable associated with recurrent SGA. A prediction model for recurrent SGA included the following independent risk factors: BW <3rd percentile, villous lesions of maternal vascular malperfusion, and neonatal to placental weight ratio. CONCLUSION: The presence of placental vascular malperfusion lesions and increased neonatal to placental weight ratio at index pregnancy are associated with recurrent SGA in subsequent pregnancy.
Entities:
Keywords:
placental pathology; small for gestational age
Authors: Michal Levy; David Alberti; Michal Kovo; Letizia Schreiber; Eldar Volpert; Liron Koren; Jacob Bar; Eran Weiner Journal: Arch Gynecol Obstet Date: 2020-04-24 Impact factor: 2.344