Department of Obstetrics and Gynecology, Amiens-Picardie University Medical Center, Amiens, France.
Department of Clinical Pathology, Amiens-Picardie University Medical Center, Amiens, France.
J Matern Fetal Neonatal Med. 2020 Jun;33(11):1895-1900. doi: 10.1080/14767058.2018.1533942. Epub 2018 Dec 9.
After a small-for-gestational-age (SGA) birth, recurrence of placenta-mediated pregnancy complications (PMPCs) is a cause for anxiety when contemplating another pregnancy. We sought to identify factors potentially associated with this recurrence. This retrospective single-center observational study was conducted in a tertiary maternity unit between 1 January 2010 and 31 December 2017. We included all women having experienced a non-syndromic SGA birth and who were subsequently monitored for at least one other pregnancy in our institution. PMPCs were defined as recurrent SGA births, three consecutive first-trimester miscarriages, or preeclampsia. Ninety-four women were included over a 7-year study period. Recurrent PMPCs were recorded in 30 (32%) cases, of which 29 featured recurrent SGA births. None of the following characteristics were significantly associated with recurrence: presence of preeclampsia during the initial pregnancy (six [20%] versus 25 [39%] cases in the recurrent PMPCs and non-recurrent PMPCs groups, respectively; = .11), results of the histopathologic placental examination or thrombophilia screen, or implemented treatment during subsequent pregnancies. PMPCs recur frequently. No risk factor for recurrence was identified in our study. Results of etiologic assessments and treatments implemented after an initial SGA birth should therefore not modify level of clinical and ultrasound monitoring provided during subsequent pregnancies. Recurrence of placenta-mediated pregnancy complications is a cause for anxiety when contemplating another pregnancy. We did not identify any risk factor after an initial small-for-gestational-age birth in our study; surveillance should therefore not be modified by the etiologic assessments' results.
小胎龄儿(SGA)出生后,再次发生胎盘介导的妊娠并发症(PMPC)是考虑再次妊娠时令人担忧的原因。我们试图确定可能与这种复发相关的因素。这项回顾性单中心观察性研究于 2010 年 1 月 1 日至 2017 年 12 月 31 日在一家三级妇产医院进行。我们纳入了所有经历过非综合征性 SGA 出生且随后在我们机构监测至少另一项妊娠的女性。PMPC 定义为复发性 SGA 出生、连续三次早期流产或子痫前期。在 7 年的研究期间,共有 94 名女性入组。30 例(32%)记录到复发性 PMPC,其中 29 例为复发性 SGA 出生。以下特征均与复发无显著相关性:初始妊娠时是否存在子痫前期(6 [20%]例与复发性 PMPC 和非复发性 PMPC 组分别为 25 [39%]例;= 0.11)、组织病理学胎盘检查或血栓形成倾向筛查的结果,或随后妊娠中实施的治疗。PMPC 经常复发。我们的研究未发现复发的危险因素。因此,初始 SGA 出生后的病因评估和治疗结果不应改变后续妊娠提供的临床和超声监测水平。当考虑再次妊娠时,胎盘介导的妊娠并发症的复发是一个令人担忧的原因。我们在研究中没有发现初始小胎龄儿出生后的任何危险因素;因此,监测不应因病因评估结果而改变。