Devarajan Karthika, Kives Sari, Ray Joel G
Department of Obstetrics and Gynecology, University of Toronto, Toronto ON.
Department of Obstetrics and Gynecology, University of Toronto, Toronto ON; Department of Medicine, St. Michael's Hospital, Toronto ON.
J Obstet Gynaecol Can. 2012 Apr;34(4):325-329. doi: 10.1016/S1701-2163(16)35212-4.
Previous studies suggest that placental location may affect fetal growth and the risks of preterm birth and preeclampsia. We studied the association between placental location and newborn weight.
We conducted a retrospective cohort study of 796 consecutive singleton births in women who delivered at ≥ 37 weeks' gestation between July and October 2009. We evaluated placental location at the time of the second trimester prenatal ultrasound at 16 to 24 weeks' gestation. Placental location was classified as lateral or central/fundal. We assessed the difference in newborn weight according to placental location and the incidence of small for gestational age birth weight < 10th percentile and pregnancy-induced hypertension. Using logistic regression analysis, odds ratios were adjusted for maternal age, world region of birth, gravidity, parity, maternal weight, history of hypertension or diabetes, current smoking or illicit drug use, and infant sex.
Among women with lateral versus central/fundal placentas, the respective mean (SD) birth weights were 3298 (550) g and 3352 (579) g (mean difference 54 g, 95% CI 53 to 161; P = 0.32). Relative to central/fundal location, laterally located placentas had an adjusted OR of 0.81 (95% CI 0.42 to 1.54) for SGA and 0.62 (95% CI 0.18 to 2.10) for preeclampsia/gestational hypertension.
Placental location was not associated with differences in newborn weight or other perinatal outcomes.
既往研究表明,胎盘位置可能影响胎儿生长以及早产和子痫前期的风险。我们研究了胎盘位置与新生儿体重之间的关联。
我们对2009年7月至10月间孕周≥37周的796例连续单胎分娩的女性进行了一项回顾性队列研究。我们在孕16至24周的孕中期产前超声检查时评估胎盘位置。胎盘位置分为侧壁或中央/宫底部。我们根据胎盘位置评估新生儿体重差异以及小于胎龄儿(出生体重<第10百分位数)和妊娠高血压的发生率。使用逻辑回归分析,对产妇年龄、出生的世界地区、孕次、产次、产妇体重、高血压或糖尿病病史、当前吸烟或使用非法药物以及婴儿性别进行比值比调整。
在胎盘位于侧壁与中央/宫底部的女性中,各自的平均(标准差)出生体重分别为3298(550)g和3352(579)g(平均差异54 g,95%可信区间53至161;P = 0.32)。相对于中央/宫底部位置,胎盘位于侧壁的小于胎龄儿调整后的比值比为0.81(95%可信区间0.42至1.54),子痫前期/妊娠高血压的调整后比值比为0.62(95%可信区间0.18至2.10)。
胎盘位置与新生儿体重差异或其他围产期结局无关。