Sehgal Arvind, Dahlstrom Jane E, Chan Yuen, Allison Beth J, Miller Suzanne L, Polglase Graeme R
Monash Newborn, Monash Children's Hospital, Melbourne, Victoria, Australia.
Department of Pediatrics, Monash University, Melbourne, Victoria, Australia.
J Paediatr Child Health. 2019 May;55(5):582-587. doi: 10.1111/jpc.14251. Epub 2018 Oct 4.
Approximately 6-9% pregnancies are affected by fetal growth restriction (FGR). Placental alterations related to utero-placental insufficiency in FGR may induce placental vascular remodelling to the detriment of the fetus. The objective of this article was to study histopathological features of placentae in a cohort of preterm growth-restricted infants in comparison to a cohort of preterm appropriately grown infants.
In a cohort of 40 preterm infants of 28-32 weeks' gestation, placental histopathology was evaluated by a histopathologist, who was blinded to the identity of the grouping. Twenty infants had FGR, while 20 were appropriate for gestational age (AGA). Predefined histopathological characteristics were assessed based on the Amsterdam Placental Workshop Group Consensus Statement.
The gestational age and birthweight of the FGR and AGA cohorts were 29.8 ± 1.3 versus 30 ± 0.9 weeks, P = 0.78 and 923 ± 168 versus 1403 ± 237 g, <0.001, respectively. Maternal vascular malperfusion, accelerated villous maturation and fetal vascular malperfusion were features that were significantly more common in FGR placentae.
Based on the results of the present study, specific placental histopathological changes may be present in FGR placentae, which may reflect the effects of utero-placental insufficiency.
约6 - 9%的妊娠受胎儿生长受限(FGR)影响。FGR中与子宫胎盘功能不全相关的胎盘改变可能会导致胎盘血管重塑,对胎儿不利。本文的目的是研究一组早产生长受限婴儿的胎盘组织病理学特征,并与一组早产且生长正常的婴儿进行比较。
在一组40例孕28 - 32周的早产婴儿中,由一名对分组情况不知情的组织病理学家评估胎盘组织病理学。20例婴儿患有FGR,20例为适于胎龄(AGA)。基于阿姆斯特丹胎盘研讨会小组共识声明评估预先定义的组织病理学特征。
FGR组和AGA组的孕周分别为29.8±1.3周和30±0.9周,P = 0.78;出生体重分别为923±168克和1403±237克,P<0.001。母体血管灌注不良、绒毛成熟加速和胎儿血管灌注不良在FGR胎盘更为常见。
基于本研究结果,FGR胎盘可能存在特定的胎盘组织病理学变化,这可能反映子宫胎盘功能不全的影响。