[Placental pathology of the small-for-gestational-age newborn infant]

The problem of the newborn that is small for its gestational age is emphasized. Fetal growth is dependent upon the growth potential of the fetus and the availability of intrauterine nutrition. Proper nourishment for optimal fetal growth will require adequate maternal and placental circulations, sufficient quantities of circulating nutrients in the maternal blood, and a proper area of placental membrane, which is capable of achieving satisfactory maternal-fetal transfer. Many factors appear to produce this syndrome including genetic anomalies, intrauterine infection and deficiencies of placenta and cord, but in most small-for-dates infantes the common underlying situation appears to be a state of intrauterine malnutrition, mediated by a maternal-fetal vascular insufficiency. Placental factor probably accounts for only a small proportion of deprived fetuses. However, the present knowledge on the histopathology of the placenta from cases of small-for-date babies is relatively poor to reach a final conclusion. More research in the direction of the maternal side of the placenta and in particular to the placental bed, including more complete study of the lesions in the uteroplacental vessels will probably clarify the problem of fetal growth retardation.