Macdonald E M, Natale R, Regnault T R H, Koval J J, Campbell M K
Department of Epidemiology and Biostatistics, The University of Western Ontario, London, Canada N6A 5C1.
Department of Obstetrics and Gynecology, The University of Western Ontario, London, Canada N6A 5C1; Department of Paediatrics, The University of Western Ontario, London, Canada N6A 5C1.
Placenta. 2014 Aug;35(8):582-6. doi: 10.1016/j.placenta.2014.04.019. Epub 2014 May 22.
To elucidate how obstetric conditions are associated with atypical placental weight ratios (PWR)s in infants born: (a) ≥37 weeks gestation; (b) at ≥33 but <37 weeks gestation; and (c) <33 weeks gestation.
The study included all in-hospital singleton births in London, Ontario between June 1, 2006 and March 31, 2011. PWR was assessed as <10th or >90th percentile by gestational age-specific local population standards. Multivariable analysis was carried out using multinomial logistic regression with blockwise variable entry in order of temporality.
Baseline factors and maternal obstetric conditions associated with PWR <10th percentile were: increasing maternal height, overweight and obese body mass indexes (BMI), large for gestational age infants, smoking, and gestational diabetes. Obstetric factors associated with PWR >90th percentile were: underweight, overweight and obese BMIs, smoking, preeclampsia, placenta previa, and placental abruption. In particular, indicators of hypoxia and altered placental function were generally associated with elevated PWR at all gestations.
An association between obstetric conditions associated with fetal hypoxia and PWR ≥90th percentile was illustrated.
The multivariable findings suggest that the PWR is similarly increased regardless of the etiology of the hypoxia.
为阐明产科情况如何与以下出生婴儿的非典型胎盘重量比(PWR)相关:(a)妊娠≥37周;(b)妊娠≥33周但<37周;以及(c)妊娠<33周。
该研究纳入了2006年6月1日至2011年3月31日安大略省伦敦市所有住院单胎分娩。根据特定孕周的当地人群标准,将PWR评估为低于第10百分位数或高于第90百分位数。使用多分类逻辑回归并按时间顺序逐块纳入变量进行多变量分析。
与PWR低于第10百分位数相关的基线因素和产妇产科情况包括:产妇身高增加、超重和肥胖体重指数(BMI)、大于胎龄儿、吸烟和妊娠期糖尿病。与PWR高于第90百分位数相关的产科因素包括:体重过轻、超重和肥胖BMI、吸烟、子痫前期、前置胎盘和胎盘早剥。特别是,缺氧和胎盘功能改变的指标通常与所有孕周的PWR升高相关。
说明了与胎儿缺氧相关的产科情况与PWR≥第90百分位数之间的关联。
多变量研究结果表明,无论缺氧的病因如何,PWR均同样升高。