Stillbirths at Term: Case Control Study of Risk Factors, Growth Status and Placental HistologyReport as inadecuate




Stillbirths at Term: Case Control Study of Risk Factors, Growth Status and Placental Histology - Download this document for free, or read online. Document in PDF available to download.

Objective

To investigate the proportion of stillbirths at term associated with abnormal growth using customized birth weight percentiles and to compare histological placental findings both in underweight stillborn fetuses and in live births.

Methods

A retrospective case-control study of 150 singleton term stillbirths. The livebirth control groups included 586 cases of low-risk pregnancies and 153 late fetal growth restriction fetuses. Stillbirths and livebirths from low-risk pregnancies were classified using customized standards for fetal weight at birth, as adequate for gestational age AGA; 10-90th percentile, small SGA; <10th percentile or large for gestational age LGA; >90th percentile. Placental characteristics in stillbirth were compared with those from livebirths using four categories: inflammation, disruptive, obstructive and adaptive lesions.

Results

There was a higher rate of SGA 26% vs 6%, p<0.001 and LGA fetuses 10.6% vs 5.6%, p<0.05 in the stillbirth group. Among stillbirth fetuses, almost half of the SGA were very low birthweight ≤3°percentile 12% vs 0.3%, p<0.001. The disruptive 7.3% vs 0.17%;p<0.001, obstructive 54.6% vs 7.5%;p<0.001 and adaptive 46.6% vs 35.8%;p<0.001 findings were significantly more common in than in livebirth-low risk. Placental characteristics of AGA and SGA stillbirth were compared with those of AGA and FGR livebirth. In stillbirths-SGA we found a higher number of disruptive 12.8% vs 0%; p<0.001, obstructive 58.9% vs 23.5%;p<0.001 and adaptive lesions 56.4% vs 49%; p 0.47 than in livebirth-FGR.

Conclusion

The assessment of fetal weight with customized curves can identify fetuses which have not reached their genetically determined growth potential and are therefore at risk for adverse outcomes. Placental evaluation in stillbirths can reveal chronic histological signs that might be useful to clinical assessment, especially in underweight fetuses.



Author: Federico Mecacci, Caterina Serena , Laura Avagliano, Mauro Cozzolino, Eleonora Baroni, Marianna Pina Rambaldi, Serena Simeone, Fr

Source: http://plos.srce.hr/



DOWNLOAD PDF




Related documents