Association Between Placental Pathology and Early-Onset Fetal Growth Restriction: A Systematic Review

Objective: Fetal growth restriction (FGR) is defined as the failure of the fetus to achieve its genetically determined growth potential. Our aim is to compare the placental lesions present in early-onset fetal growth restriction with that of late-onset FGR. Methods: We performed a systematic review according to the PRISMA guideline. Observational studies, only in singleton pregnancies, evaluating the association between fetal growth restriction and placental lesions in early- versus late-onset FGR were included. Results: We included six articles. All studies showed a higher rate of maternal vascular malperfusion (MVM) lesions in the early-onset FGR groups when compared to late-onset ones. Five articles reported that early-onset FGR is often associated with pre-eclampsia. Conclusion: This review shows that early-onset FGR cases are associated with specific placental histopathology, such as maternal vascular malperfusion lesions. Placental histopathological examination is important to better understand the pathophysiology of FGR.