Birth weight to placenta weight ratio and its relationship to ultrasonic measurements, maternal and neonatal morbidity: A prospective cohort study of nulliparous women

Salavati, Nastaran; Gordijn, Sanne J.; Sovio, Ulla; Zill‐E‐Huma, Rabia; Gebril, Amr; Charnock-Jones, D. Stephen; Scherjon, SA; Smith, Gordon C. S.

doi:10.1016/j.placenta.2017.11.008

Cited by 35 publications

(38 citation statements)

References 30 publications

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“…Ratios and residuals were also lower in newborns with lower Apgar scores and reduced prospects of postnatal survival. Previously, fetal death has been found to be associated with very high and very low BW:PW ratio preterm, and very high BW:PW ratio at term [16] whereas a recent study found that low BW:PW ratio at term was associated with neonatal morbidity (defined in terms of low Apgar score, metabolic acidosis and/or admission to the neonatal unit) [17]. In the present study, residuals almost always showed differences at least as great as the BW:PW ratio in terms of the magnitude of difference between placentas with and without pathology, or between adverse and normal outcomes.…”

Section: Discussionmentioning

confidence: 96%

The problem with using the birthweight:placental weight ratio as a measure of placental efficiency

et al. 2018

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The BW:PW ratio produced an artefact whereby histologically less mature placentas at term appeared to be more "efficient" than mature placentas, illustrating a known problem with the use of ratios. For other traits, residuals generally showed differences between placentas with and without pathology that were as great as those seen with BW:PW ratios, and often showed stronger associations with adverse outcomes.

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Section: Discussionmentioning

confidence: 96%

The problem with using the birthweight:placental weight ratio as a measure of placental efficiency

et al. 2018

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“…Placental weight was obtained from medical records and measured according to standard protocols [15]. Birth weight:placental weight ratio was calculated, as indicator of the ability of the placenta to maintain adequate nutrient supply to the fetus, and is associated with neonatal morbidity and mortality [16]. Small-size for gestational age (SGA) was defined as gestational age adjusted birth weight <10th percentile.…”

Section: Placental Vascular Function and Placental Weight At Birthmentioning

confidence: 99%

Associations of maternal age at the start of pregnancy with placental function throughout pregnancy: The Generation R Study

Erkamp

Jaddoe

Mulders

et al. 2020

European Journal of Obstetrics & Gynecology and Reproductiv

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To examine the associations of maternal age at the start of pregnancy across the full range with second and third trimester uterine and umbilical artery flow indices, and placental weight. Study design: In a population-based prospective cohort study among 8271 pregnant women, we measured second and third trimester uterine artery resistance and umbilical artery pulsatility indices and the presence of third trimester uterine artery notching using Doppler ultrasound. Results: Compared to women aged 25À29.9 years, higher maternal age was associated with a higher third trimester uterine artery resistance index (difference for women 30À34.9 years was 0.10 SD (95% Confidence Interval (CI) 0.02 to 0.17), and for women aged !40 years 0.33 SD (95% CI 0.08 to 0.57), overall linear trend 0.02 SD (95% CI 0.01 to 0.03) per year). Compared to women aged 25À29.9 years, women younger than 20 years had an increased risk of third trimester uterine artery notching (Odds Ratio (OR) 1.97 (95% CI 1.30-3.00)). A linear trend was present with a decrease in risk of third trimester uterine artery notching per year increase in maternal age (OR 0.96 (95% CI 0.94 to 0.98)). Maternal age was not consistently associated with umbilical artery pulsatility indices or placental weight. Conclusions: Young maternal age is associated with higher risk of third trimester uterine artery notching, whereas advanced maternal age is associated with a higher third trimester uterine artery resistance index, which may predispose to an increased risk of pregnancy complications.

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“…Research showed that not only the size and weight of the placenta, but also the weight of the placenta in relation to birth weight was associated with both umbilical and uterine artery PI (Salavati et al, 2018). Specifically, high BWPW-ratio was associated with both higher umbilical artery PI (26 weeks of gestation) and higher uterine artery PI (20 weeks of gestation), two markers of decreased placental function.…”

Section: Clinical Relevance Of Antenatal and Postnatal Assessment Of mentioning

confidence: 99%

“…Specifically, high BWPW-ratio was associated with both higher umbilical artery PI (26 weeks of gestation) and higher uterine artery PI (20 weeks of gestation), two markers of decreased placental function. Low BWPW-ratio was not associated with either umbilical or uterine artery PI, however it was with maternal and neonatal morbidity (Salavati et al, 2018). Decreased placental function may sound contradictory, since placentas in the group of high BWPW-ratio can also be seen as very efficient.…”

Section: Clinical Relevance Of Antenatal and Postnatal Assessment Of mentioning

confidence: 99%

The Possible Role of Placental Morphometry in the Detection of Fetal Growth Restriction

et al. 2019

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Fetal growth restriction (FGR) is often the result of placental insufficiency and is characterized by insufficient transplacental transport of nutrients and oxygen. The main underlying entities of placental insufficiency, the pathophysiologic mechanism, can broadly be divided into impairments in blood flow and exchange capacity over the syncytiovascular membranes of the fetal placenta villi. Fetal growth restriction is not synonymous with small for gestational age and techniques to distinguish between both are needed. Placental insufficiency has significant associations with adverse pregnancy outcomes (perinatal mortality and morbidity). Even in apparently healthy survivors, altered fetal programming may lead to long-term neurodevelopmental and metabolic effects. Although the concept of fetal growth restriction is well appreciated in contemporary obstetrics, the appropriate detection of FGR remains an issue in clinical practice. Several approaches have aimed to improve detection, e.g., uniform definition of FGR, use of Doppler ultrasound profiles and use of growth trajectories by ultrasound fetal biometry. However, the role of placental morphometry (placental dimensions/shape and weight) deserves further exploration. This review article covers the clinical relevance of placental morphometry during pregnancy and at birth to help recognize fetuses who are growth restricted. The assessment has wide intra- and interindividual variability with various consequences. Previous studies have shown that a small placental surface area and low placental weight are associated with a slower growth of the fetus. Parameters such as placental surface area, placental volume and placental weight in relation to birth weight can help to identify FGR. In the future, a model including sophisticated antenatal placental morphometry may prove to be a clinically useful method for screening or diagnosing growth restricted fetuses, in order to provide optimal monitoring.

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Birth weight to placenta weight ratio and its relationship to ultrasonic measurements, maternal and neonatal morbidity: A prospective cohort study of nulliparous women

Abstract: BWPW-ratio is related to ultrasonic measurements and both neonatal and maternal morbidity. Therefore, this ratio may be an indicative marker of immediate and longer term health risks for an individual.

Cited by 35 publications

References 30 publications

The problem with using the birthweight:placental weight ratio as a measure of placental efficiency

The problem with using the birthweight:placental weight ratio as a measure of placental efficiency

Associations of maternal age at the start of pregnancy with placental function throughout pregnancy: The Generation R Study

The Possible Role of Placental Morphometry in the Detection of Fetal Growth Restriction

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