Increased Placental Calcifications in Fetal Skeletal Dysplasias

Placental calcifications are common and often associated with post-term placentas and maternal vascular disorders. However, their significance in specific fetal disease contexts remains poorly understood. Anecdotally, placentas belonging to fetuses with skeletal dysplasias (SD) often demonstrate increased placental calcifications. Our aim was to systematically evaluate calcification patterns in SD placentas.

Retrospective case-control study of molecularly confirmed SD placentas (2016-2025) and controls. One perinatal pathologist reviewed gross features and performed histologic evaluation of cases and controls. Placental calcifications were scored using a unique calcification scoring system.

SD cases had a higher total calcification score than controls (P < .001). SD cases were more likely to have larger calcification patterns (P = .013) as well as a higher grade of calcifications (P = .001). Calcification scores were also statistically significantly higher for both the <30 weeks gestational age (GA) group (P = .002) and the >36 weeks GA group (P = .013).

Increased placental calcifications were seen in cases of fetal SD across GAs. While SD calcifications tended to be smaller at earlier GAs, they were higher in frequency compared to controls. Although some calcifications can be attributed to placental aging, the term SD cases showed significantly increased scores in comparison.