Very low birthweight infant's placenta and its relation to pregnancy and fetal characteristics

Anne R. Hansen, Margaret H. Collins, David Genest, Debra Heller, Susan Schwarz, Petra Banagon, Elizabeth N. Allred, Alan Leviton

Research output: Contribution to journalArticlepeer-review

31 Scopus citations

Abstract

Our objective was to relate pathology of the very low birthweight (VLBW) infant's placenta to pregnancy and fetal characteristics. We correlated the pathologic features of 1146 placentas from infants with birth weights of 500- 1500 g who were born between 1/1/91 and 12/31/93 to the number of gestations per pregnancy, initiator of preterm delivery, gestational age, birth weight Z score, and duration of rupture of membrane (ROM). Placental correlates of acute inflammation and villous edema were associated with preterm labor (PTL), prelabor premature rupture of membranes (PROM), lower gestational age, and higher birth weight Z score. In PTL pregnancies delivered within 1 h of membrane rupture, 61% of placentas already had membrane inflammation. Placental correlates of pregnancy-induced hypertension (PIH) were seen more commonly with PIH pregnancies, older gestational age, and lower birth weight Z score. We found a more prominent histopathologic signature for singleton than for multiple gestation placentas. The placental pathologic findings associated with the clinical diagnoses of infection, PIH, and low-birth weight Z scores in our VLBW/preterm population are similar to those in the literature regarding term pregnancies. The presence of multiple histologic findings consistent with inflammation in placentas of PTL pregnancies with duration of ROM lasting <1 h suggests that some cases of PTL are precipitated by a more long-standing infection than that previously suspected. Morphologic placental features appear to be correlates of the phenomena leading to premature delivery. Examination of the VLBW infant's placenta provides insight into the etiology and management of VLBW/preterm deliveries.

Original languageEnglish (US)
Pages (from-to)419-430
Number of pages12
JournalPediatric and Developmental Pathology
Volume3
Issue number5
DOIs
StatePublished - 2000

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Pathology and Forensic Medicine

Keywords

  • Placenta
  • Preterm
  • Very low birth weight

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