Freedman Alexa A, Hogue Carol J, Marsit Carmen J, Rajakumar Augustine, Smith Alicia K, Goldenberg Robert L, Dudley Donald J, Saade George R, Silver Robert M, Gibbins Karen J, Stoll Barbara J, Bukowski Radek, Drews-Botsch Carolyn
1 Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.
2 Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia.
Pediatr Dev Pathol. 2019 May-Jun;22(3):194-204. doi: 10.1177/1093526618789310. Epub 2018 Jul 16.
The placenta plays a critical role in regulating fetal growth. Recent studies suggest that there may be sex-specific differences in placental development. The purpose of our study was to evaluate the associations between birthweight and placental morphology in models adjusted for covariates and to assess sex-specific differences in these associations. We analyzed data from the Stillbirth Collaborative Research Network's population-based case-control study conducted between 2006 and 2008, which recruited cases of stillbirth and population-based controls in 5 states. Our analysis was restricted to singleton live births with a placental examination (n = 1229). Characteristics of placental morphology evaluated include thickness, surface area, difference in diameters, shape, and umbilical cord insertion site. We used linear regression to model birthweight as a function of placental morphology and covariates. Surface area had the greatest association with birthweight; a reduction in surface area of 83 cm, which reflects the interquartile range, is associated with a 260.2-g reduction in birthweight (95% confidence interval, -299.9 to -220.6), after adjustment for other features of placental morphology and covariates. Reduced placental thickness was also associated with lower birthweight. These associations did not differ between males and females. Our results suggest that reduced placental thickness and surface area are independently associated with lower birthweight and that these relationships are not related to sex.
胎盘在调节胎儿生长方面起着关键作用。最近的研究表明，胎盘发育可能存在性别差异。我们研究的目的是在调整协变量的模型中评估出生体重与胎盘形态之间的关联，并评估这些关联中的性别差异。我们分析了死产协作研究网络在2006年至2008年期间进行的基于人群的病例对照研究的数据，该研究在5个州招募了死产病例和基于人群的对照。我们的分析仅限于有胎盘检查的单胎活产（n = 1229）。评估的胎盘形态特征包括厚度、表面积、直径差异、形状和脐带插入部位。我们使用线性回归将出生体重建模为胎盘形态和协变量的函数。表面积与出生体重的关联最大；在调整了胎盘形态的其他特征和协变量后，表面积减少83平方厘米（反映四分位间距）与出生体重减少260.2克相关（95%置信区间，-299.9至-220.6）。胎盘厚度降低也与较低的出生体重相关。这些关联在男性和女性之间没有差异。我们的结果表明，胎盘厚度和表面积降低与较低的出生体重独立相关，并且这些关系与性别无关。
