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Association Between Lateral Placenta and Adverse Maternal and Perinatal Outcomes: A Systematic Review and
Joseph Arkorful1,2, Juliana Nyamson2, Theophilus Adu-Bredu3
1Department of Obstetrics, Division Woman and Baby, Wilhelmina Children Hospital, University Medical Center, Utrecht University, Utrecht, the Netherlands.
Summary
Lateral placenta is linked to higher risks of preeclampsia, small-for-gestational age (SGA) infants, and preterm birth. Further research is needed to fully understand these associations after adjusting for confounding factors.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Reproductive Health
Background:
- Adverse maternal and perinatal outcomes like preeclampsia, small-for-gestational age (SGA), and preterm birth are significant global health issues.
- Emerging evidence suggests a link between lateral placentation and impaired uteroplacental blood flow, potentially leading to placental dysfunction and adverse outcomes.
Purpose of the Study:
- To conduct a comprehensive review and synthesis of existing evidence on the association between lateral placenta and adverse maternal and perinatal outcomes.
- To pool both crude and adjusted effect estimates from relevant studies.
Main Methods:
- A systematic search of MEDLINE (PubMed), EMBASE, Scopus, and Cochrane CENTRAL was performed.
- Meta-analyses were conducted on data extracted from 21 eligible studies involving 162,727 singleton pregnancies.
- Random-effects models were used to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs), with heterogeneity assessed using I² statistic and Cochran's Q test.
Main Results:
- Lateral placenta was associated with increased odds of preeclampsia (OR=1.65), SGA (OR=1.40), preterm birth <34 weeks (OR=2.10), preterm birth <37 weeks (OR=1.50), retained placenta (OR=2.52), and non-vertex presentation (OR=1.50).
- Pooled adjusted analyses showed increased odds for SGA (aOR=1.84) and retained placenta (aOR=4.43).
- Adjusted analyses also indicated increased odds for preterm birth <34 weeks (aOR=2.14) and <37 weeks (aOR=1.54).
Conclusions:
- Lateral placenta is associated with higher odds of preeclampsia, SGA, preterm birth, non-vertex presentation, and retained placenta.
- After adjusting for confounders, lateral placenta remained significantly associated with increased odds of SGA, preterm birth, and retained placenta.
- Further research with adjusted analyses is recommended to strengthen the evidence base for these independent associations.
