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Placental infarcts in the collaborative perinatal project: Variable associations infer variable constructs.

Dawn P Misra1, Sarah McNally2, Serena Chen3

  • 1Michigan State University College of Human Medicine, East Lansing, MI, USA.

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|July 28, 2020
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Summary

Diagnoses of placental infarcts showed variable associations with birth outcomes across study sites. Refined infarct scoring is needed to understand their lifelong health impacts.

Keywords:
BirthweightPlacental efficiencyPlacental infarct

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Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Medicine
  • Pathology

Background:

  • Placental infarcts are common findings during pregnancy.
  • Accurate assessment of placental infarcts is crucial for understanding their clinical significance and potential impact on fetal development.
  • Previous studies have explored associations between infarcts and birth outcomes, but consistency across different settings is unclear.

Purpose of the Study:

  • To investigate the consistency of associations between placental infarct features and measures of birthweight, placental weight, and placental efficiency across multiple study sites.
  • To determine if placental infarct diagnoses are reproducible and can reliably indicate clinical significance.

Main Methods:

  • Utilized data from 12 study sites of the National Collaborative Perinatal Project.
  • Pathologists scored infarcts based on color (indicating age), size, location, and total number.
  • Analyzed associations between infarct features and birthweight, placental weight, and placental efficiency.

Main Results:

  • High variability was observed in infarct incidence and feature distributions across study sites.
  • Associations between infarct features and birthweight/placental efficiency varied significantly between sites.
  • The most consistent associations were between placental infarct scores and placental size/shape and birthweight.

Conclusions:

  • Current placental infarct (CPP) scoring lacks consistency across sites, limiting its use as an indicator of a shared pathophysiologic construct.
  • Despite variability, infarct features should be clarified and refined, not discarded, to better understand their role in lifelong health.
  • Further research is needed to standardize infarct assessment for accurate correlation with child and adult health outcomes.