Matsuda Yoshio, Ogawa Masaki, Nakai Akihito, Hayashi Masako, Satoh Shoji, Matsubara Shigeki
1. Department of Obstetrics and Gynecology, Professor, International University of Health and Welfare Hospital, Professor, 537-3 Iguchi Nasushiobara, Tochigi 329-2763, Japan.
2. Department of Obstetrics and Gynecology, Tokyo Women's Medical University, Associate professor, Kawada-cho, 8-1, Shinjuku-ku, Tokyo 162-8666, Japan.
Int J Med Sci. 2015 Mar 25;12(4):301-5. doi: 10.7150/ijms.11644. eCollection 2015.
The "inappropriately heavy placenta" has been considered to be associated with various pregnancy disorders; however, data is scarce what factors affect it. To determine whether the following three affect it; (1) infant gender and mother's parity, (2) growth restriction, and (3) preeclampsia.
We employed fetal/placental weight ratio (F/P). Subjects consisted of 53,650 infants and their placentas from women who vaginally delivered singleton live term infants. First, we examined whether F/P differs among the infant's gender or mother's parity. We classified the population into 4 categories according to gender and parity: male, nulliparous (n=7,431), male, multiparous (n=7,859), female, nulliparous (n=7,559), female, multiparous (n=7,800), and, compared F/P among the four groups. Next, we determined whether F/P differs in "small" or "large" for gestational age (SGA or LGA) infants, compared with appropriate for gestational age infants. Last, we determined whether preeclampsia (representative disorder of SGA) affects F/P.
(1) F/P significantly differed according to infant gender and parity: female and nulliparity had significantly smaller F/P. F/P was significantly smaller in (2) SGA infants, and (3) infants from preeclamptic mothers.
We for the first time showed that in Japanese term vaginally-delivered singleton population, the following three had significantly smaller F/P than controls thus had "inappropriately heavy placenta": (1) female gender and nulliparity, (2) SGA infants, and (3) infants from preeclamptic mothers. We recommend that these factors should be taken into account in evaluating placental weight. These data may also be useful for further clarifying the fetal-placental pathophysiology in these conditions.
“胎盘过重异常”被认为与多种妊娠疾病相关;然而,关于影响它的因素的数据却很稀少。为了确定以下三个因素是否对其有影响:(1)婴儿性别和母亲的胎次,(2)生长受限,以及(3)先兆子痫。
我们采用胎儿/胎盘重量比(F/P)。研究对象包括53650例经阴道分娩单胎足月活产婴儿及其胎盘的女性。首先,我们检查了F/P在婴儿性别或母亲胎次之间是否存在差异。我们根据性别和胎次将人群分为4类:男性、初产妇(n = 7431),男性、经产妇(n = 7859),女性、初产妇(n = 7559),女性、经产妇(n = 7800),并比较了这四组之间的F/P。接下来,我们确定与适于胎龄儿相比,F/P在小于胎龄(SGA)或大于胎龄(LGA)婴儿中是否存在差异。最后,我们确定先兆子痫(SGA的代表性疾病)是否影响F/P。
(1)F/P根据婴儿性别和胎次有显著差异:女性和初产的F/P显著更小。(2)SGA婴儿以及(3)患先兆子痫母亲所生婴儿的F/P显著更小。
我们首次表明,在日本足月经阴道分娩的单胎人群中,以下三者的F/P显著小于对照组,因此存在“胎盘过重异常”:(1)女性性别和初产,(2)SGA婴儿,以及(3)患先兆子痫母亲所生婴儿。我们建议在评估胎盘重量时应考虑这些因素。这些数据也可能有助于进一步阐明这些情况下的胎儿 - 胎盘病理生理学。