Document Detail

The epidemiology of placental features: associations with gestational age and neonatal outcome.
MedLine Citation:
PMID:  8677084     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To investigate the epidemiologic and pathogenetic significance of placental features and neonatal outcome in a high-risk population. METHODS: One pathologist examined 1252 placentas from clinically selected at-risk singleton pregnancies. Placental pathology features were analyzed relative to gestational age and status of the newborn, including fetal growth restriction (FGR), low 1-minute Apgar score, infection, liver disorder, anomalies, and death in the immediate postnatal period. RESULTS: The most frequent placental pathologic features were ischemic change, meconium staining, and chorioamnionitis. Only 8% of placentas were considered normal. The number of features per placenta increased with gestational age. Among preterm infants, chorioamnionitis occurred most frequently with low 1-minute Apgar score (40%), clinically apparent infection (43%), liver disorder (43%), and anomalies (42%), compared with healthy newborns (15%). Chorioamnionitis at term was most frequent among infants with low 1-minute Apgar score (26%), infection (30%), and liver disorder (23%), compared with healthy newborns (16%). Meconium and ischemic changes were most frequent in placentas from healthy newborns, compared with affected newborns, regardless of gestational age. Multivariable analyses revealed an independent association between chorioamnionitis and low 1-minute Apgar score (P < .05), and both chorioamnionitis and villitis were associated with newborn infection (P < .05). CONCLUSION: The frequency of many major pathologic placental features, especially ischemic changes and meconium, in the absence of immediately detectable abnormality is relatively high. Thus, continued follow-up is needed to determine their long-term clinical significance. In addition, associations of ischemic changes and infarction with FGR in term infants suggest that need for comprehensive investigations of the effects of histopathologically apparent low placental blood flow.
L A Beebe; L D Cowan; G Altshuler
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  87     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  1996 May 
Date Detail:
Created Date:  1996-08-15     Completed Date:  1996-08-15     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  771-8     Citation Subset:  AIM; IM    
Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, USA.
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MeSH Terms
Apgar Score
Chorioamnionitis / epidemiology,  pathology
Gestational Age
Infant, Newborn
Infant, Newborn, Diseases / epidemiology
Infant, Premature, Diseases / epidemiology
Logistic Models
Multivariate Analysis
Placenta / pathology*
Placenta Diseases / epidemiology*,  pathology
Pregnancy Outcome / epidemiology*
Pregnancy, High-Risk*

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