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Published on: March 29, 2018
Pathological examination of the placenta in small for gestational age (SGA) children with or without postnatal
Makiko Tachibana1, Masahiro Nakayama2, Shinobu Ida2
1a Department of Pediatrics , Osaka University Graduate School of Medicine , Suita , Osaka , Japan and.
Insights
Placental pathology impacts postnatal growth in small for gestational age (SGA) infants. Fetal-related placental issues are linked to a lower catch-up growth rate in these newborns.
Area of Science:
- Perinatal Medicine
- Neonatology
- Pathology
Background:
- Small for gestational age (SGA) infants comprise about 10% of newborns and may experience growth challenges.
- The connection between placental abnormalities and postnatal growth in SGA infants is not fully understood.
- Investigating placental pathology is crucial for understanding growth outcomes in SGA neonates.
Purpose of the Study:
- To determine the association between placental pathology and postnatal growth in SGA infants born at term.
- To identify specific placental abnormalities that may impede catch-up growth.
Main Methods:
- Retrospective analysis of placental pathology and postnatal growth in term SGA infants (birth weight/length < -2 SDS).
- Catch-up growth defined as reaching -2 SDS height before age two.
- Placental pathology categorized into maternal, fetal factors, villitis of unknown etiology (VUE), other, or no abnormality.
Main Results:
- Out of 33,084 infants, 142 met SGA criteria; 49 had analyzable data.
- An overall catch-up growth rate of 84% was observed.
- Infants with no placental abnormality achieved catch-up growth, while only 57% with fetal-factor related abnormalities did.
Conclusions:
- Placental pathology is significantly associated with postnatal growth trajectories in term SGA infants.
- Abnormalities in the placenta stemming from fetal factors correlate with a reduced rate of catch-up growth.
Background/Objective:
Approximately 10% of small for gestational age (SGA) infants fail to catch up. The relationship between postnatal growth and placental pathology in SGA infants remains unclear. Our aim was to assess the involvement of placental pathology in postnatal growth of SGA infants.
Methods:
We retrospectively evaluated placental pathology and postnatal growth in single-pregnancy infants born after 37 gestational weeks in our institution, with both birth weight and length below -2 standard deviation scores (SDS) of the normal weight and length. "Catch-up" was defined as height reaching -2 SDS before the second birthday. Pathology of the placenta was classified into: abnormality due to maternal factors or fatal factors, villitis of unknown etiology (VUE), other abnormalities and no abnormality.
Results:
Of the 33 084 infants, 142 met our criteria and 49 of them had analyzable data. The overall catch-up rate was 84%. Catch-up growth took place in all infants with no placental abnormality and only 57% of infants with abnormality due to fatal factors. There was no significant relationship between catch-up rate and other factors.
Conclusion:
Placental pathology is associated with postnatal growth in SGA children born at term. Placental abnormality due to fetal factors is related to poor catch-up rate.
