The effect of placenta previa on fetal growth and pregnancy outcome, in correlation with placental pathology

Weiner, Eran; Miremberg, Hadas; Grinstein, Ehud; Mizrachi, Yossi; Schreiber, Letizia; Bar, Jacob; Kovo, Michal

doi:10.1038/jp.2016.140

Cited by 34 publications

(27 citation statements)

References 43 publications

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“…They hypothesized that placentation in the lower segment of the uterus is associated with suboptimal vascular development of both the uteroplacental and umbilicoplacental circulations. Compared with the present study, their rate of active smokers was more than double and 13% of their patients had thrombophilia 10,11 . Both maternal smoking 22 and thrombophilia 23 are associated with poor placental development, FGR and a higher incidence of placental vascular lesions.…”

Section: Comparison With Previous Studies and Clinical Implicationscontrasting

confidence: 88%

“…Weiner et al . did not match their cases and controls for maternal smoking status or gestational age at delivery. Their patients with placenta previa were delivered on average 3 weeks before the controls without placenta previa, making the evaluation of placental weight and fetal birth weight inaccurate.…”

Section: Discussionmentioning

confidence: 99%

“…In a controlled study of 119 cases with vs 199 without previa placenta matched for maternal complications, Weiner et al found that placenta previa was associated significantly with delivery of a SGA neonate, a smaller placenta and a higher incidence of vascular lesions secondary to maternal malperfusion and fetal thrombo-occlusive disease 10 . Although mean birth weight in the placenta previa group was 700 g higher than in the control group, the incidence of SGA with birth weight < 10 th and < 5 th percentiles was significantly higher in the placenta previa group 10 . In a secondary analysis of the placenta previa group, they found that placental size was smaller and the incidence of placental tissue vascular lesions was higher in symptomatic women compared with asymptomatic women 11 .…”

Section: Comparison With Previous Studies and Clinical Implicationsmentioning

confidence: 99%

“…Both maternal smoking 22 and thrombophilia 23 are associated with poor placental development, FGR and a higher incidence of placental vascular lesions. Weiner et al did not match their cases and controls for maternal smoking status or gestational age at delivery 10,11 . Their patients with placenta previa were delivered on average 3 weeks before the controls without placenta previa, making the evaluation of placental weight and fetal birth weight inaccurate.…”

Section: Comparison With Previous Studies and Clinical Implicationsmentioning

confidence: 99%

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Impact of placenta previa with placenta accreta spectrum disorder on fetal growth

Jauniaux

Dimitrova

Kenyon

et al. 2019

Ultrasound in Obstet & Gyne

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Objectives To evaluate fetal growth in pregnancies complicated by placenta previa with or without placenta accreta spectrum (PAS) disorder, compared with in pregnancies with a low‐lying placenta. Methods This was a multicenter retrospective cohort study of singleton pregnancies complicated by placenta previa with or without PAS disorder, for which maternal characteristics, ultrasound‐estimated fetal weight and birth weight were available. Four maternal–fetal medicine units participated in data collection of diagnosis, treatment and outcome. The control group comprised singleton pregnancies with a low‐lying placenta (0.5–2 cm from the internal os). The diagnosis of PAS and depth of invasion were confirmed at delivery using both a predefined clinical grading score and histopathological examination. For comparison of pregnancy characteristics and fetal growth parameters, the study groups were matched for smoking status, ethnic origin, fetal sex and gestational age at delivery. Results The study included 82 women with placenta previa with PAS disorder, subdivided into adherent (n = 35) and invasive (n = 47) PAS subgroups, and 146 women with placenta previa without PAS disorder. There were 64 controls with a low‐lying placenta. There was no significant difference in the incidence of small‐for‐gestational age (SGA) (birth weight ≤ 10th percentile) and large‐for‐gestational age (LGA) (birth weight ≥ 90th percentile) between the study groups. Median gestational age at diagnosis was significantly lower in pregnancies with placenta previa without PAS disorder than in the low‐lying placenta group (P = 0.002). No significant difference was found between pregnancies complicated by placenta previa with PAS disorder and those without for any of the variables. Median estimated fetal weight percentile was significantly lower in the adherent compared with the invasive previa–PAS subgroup (P = 0.047). Actual birth weight percentile at delivery did not differ significantly between the subgroups (P = 0.804). Conclusions No difference was seen in fetal growth in pregnancies complicated by placenta previa with PAS disorder compared with those without and compared with those with a low‐lying placenta. There was also no increased incidence of either SGA or LGA neonates in pregnancies with placenta previa and PAS disorder compared with those with placenta previa with spontaneous separation of the placenta at birth. Adverse neonatal outcome in pregnancies complicated by placenta previa and PAS disorder is linked to premature delivery and not to impaired fetal growth. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

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Section: Comparison With Previous Studies and Clinical Implicationscontrasting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Comparison With Previous Studies and Clinical Implicationsmentioning

confidence: 99%

Section: Comparison With Previous Studies and Clinical Implicationsmentioning

confidence: 99%

See 2 more Smart Citations

Impact of placenta previa with placenta accreta spectrum disorder on fetal growth

Jauniaux

Dimitrova

Kenyon

et al. 2019

Ultrasound in Obstet & Gyne

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“…using our standard protocol. Placental lesions were classified according to the criteria adopted by the Society for Pediatric Pathology [26,27] and as previously reported by us [33,34]. Briefly, placental weight was determined 24 h after delivery, and the placental weight percentile was determined according to placental weight charts for singletons and twins [35].…”

Section: Placental Examinationmentioning

confidence: 99%

Placental Component and Pregnancy Outcome in Singleton versus Twin Pregnancies Complicated by Preeclampsia

Weiner¹,

Feldstein²,

Schreiber

et al. 2017

Fetal Diagn Ther

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Objective: To compare placental histopathological lesions and pregnancy outcomes in singleton and twin pregnancies complicated by preeclampsia (PE). Methods: Maternal characteristics, neonatal outcomes, and placental histopathology reports of pregnancies complicated by PE between January 2008 and October 2016 were reviewed. Results were compared between singletons (singleton group) and dichorionic-diamniotic twins (twin group). Placental lesions were classified into maternal and fetal vascular supply lesions. Small for gestational age (SGA) was defined as birth weight ≤10th percentile. Composite adverse neonatal outcome was defined as one or more early neonatal complications. Results: Compared to the twin group (n = 67), the singleton group (n = 275) was characterized by lower maternal age (p = 0.003), higher gestational age (p < 0.001), higher rates of previous PE (p = 0.017), chronic hypertension (p = 0.036), and severe features (p < 0.001). Placentas from the singleton group were characterized by higher rates of maternal vascular malperfusion lesions (p < 0.001) and fetal vascular supply lesions (p = 0.002). Using multivariable regression analysis, composite maternal and fetal vascular malperfusion lesions were independently associated with singletons (aOR = 2.7, 95% CI = 1.2-7.8, p < 0.001, and aOR = 1.2, 95% CI = 1.2-5.6, p = 0.025, respectively). SGA was more common in the singleton group (p = 0.002). Neonatal outcome did not differ between the groups. Conclusion: Placentas from singleton pregnancies complicated by PE were characterized by higher rates of maternal and fetal vascular lesions compared to those from twin pregnancies, suggesting that different mechanisms participate in the development of PE in these two groups.

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Cumulative Antenatal Risk and Kindergarten Readiness in Preterm-Born Preschoolers

Heitzer

Piercy

Peters

et al. 2019

Res Child Adolesc Psychopathol

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A suboptimal intrauterine environment is thought to increase the probability of deviation from the typical neurodevelopmental trajectory, potentially contributing to the etiology of learning disorders. Yet the cumulative influence of individual antenatal risk factors on emergent learning skills has not been sufficiently examined. We sought to determine whether antenatal complications, in aggregate, are a source of variability in preschoolers' kindergarten readiness, and whether specific classes of antenatal risk play a prominent role. We recruited 160 preschoolers (85 girls; ages 3-4 years), born ≤33 6 / 7 weeks' gestation, and reviewed their hospitalization records. Kindergarten readiness skills were assessed with standardized intellectual, oral-language, prewriting, and prenumeracy tasks. Cumulative antenatal risk was operationalized as the sum of complications identified out of nine common risks. These were also grouped into four classes in follow-up analyses: complications associated with intra-amniotic infection, placental insufficiency, endocrine dysfunction, and uteroplacental bleeding. Linear mixed model analyses, adjusting for sociodemographic and medical background characteristics (socioeconomic status, sex, gestational age, and sum of perinatal complications) revealed an inverse relationship between the sum of antenatal complications and performance in three domains: intelligence, language, and prenumeracy (p = 0.003, 0.002, 0.005, respectively). Each of the four classes of antenatal risk accounted for little variance, yet together they explained 10.5%, 9.8%, and 8.4% of the variance in the cognitive, literacy, and numeracy readiness domains, respectively. We conclude that an increase in the co-occurrence of antenatal complications is moderately linked to poorer kindergarten readiness skills even after statistical adjustment for perinatal risk.

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The effect of placenta previa on fetal growth and pregnancy outcome, in correlation with placental pathology

Abstract: More placental vascular supply lesions, higher rate of SGA and worse neonatal outcome characterized pregnancies with placenta previa in the current study. These findings may suggest that abnormal placentation is accompanied by suboptimal implantation that interferes with fetal growth.

Cited by 34 publications

References 43 publications

Impact of placenta previa with placenta accreta spectrum disorder on fetal growth

Impact of placenta previa with placenta accreta spectrum disorder on fetal growth

Placental Component and Pregnancy Outcome in Singleton versus Twin Pregnancies Complicated by Preeclampsia

Cumulative Antenatal Risk and Kindergarten Readiness in Preterm-Born Preschoolers

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