Placental features in preterm births may aid predictions of neonatal outcomes

Access to the full content of this site is available only to registered healthcare professionals. Register to read more

Takeaway

  • Placental pathology correlates with subtypes of preterm deliveries.

Why this matters

  • Placental pathology can be used to gain insight into subtypes of preterm birth.
  • The occurrence of placental malperfusion and inflammation/infection may be an unrecognized subtype linked to severe adverse neonatal outcomes.

Key results

  • Women with late, moderate, and early preterm birth were more likely to have placentas <10th percentile in weight compared with term pregnancies (22.2%, 43.6%, 32.9% vs 19.2%; P<.0001).
  • Women with late, moderate, and early preterm birth were more likely to have placentas with malperfusion compared with term infants (45.5%, 63.2%, 46.2% vs 32.8%; P<.0001).
  • Early preterm birth more likely to have severe intrauterine inflammation/infection (51%).
  • Mild inflammation/infection most common in term pregnancies (19.6%).

Study design

  • Data on singleton live births between 2008 and 2012 were collected retrospectively using the Magee Obstetric and Infant database (n=45,638).
  • Preterm births were further classified as late, moderate, and early.
  • Placental pathologies were categorized as maternal malperfusion, intrauterine inflammation/infection (mild, severe), or normal.
  • Funding: Supported by a grant from the Commonwealth of Pennsylvania, Department of Health.

Limitations

  • Pathology interpretation subject to interobserver variability.
  • Data limited to cases that were referred for placental pathology, bias towards prematurity may exist.