Rais Rehan, Starikov Roman, Robert Wu, Has Phinnara, He Mai
Washington University in St Louis, Department of Pathology and Immunology, St. Louis, MO, USA.
Women and Infants Hospital of Rhode Island, 101 Dudley St., Providence, RI, 02905, USA; Alpert Medical School of Brown University, 222 Richmond St., Providence, RI, 02903, USA; Phoenix Perinatal Associates Phoenix, 3877N 7th St #400, AZ, 85014, USA.
Pathol Res Pract. 2019 Mar;215(3):405-409. doi: 10.1016/j.prp.2018.12.029. Epub 2018 Dec 26.
Studies have demonstrated an association between pregestational diabetes (preGDM) and a higher prevalence of large-for-gestational age placentas (LGA). However, frequency of placental pathologies and perinatal outcomes in LGA placentas is lacking. We aimed to determine differences in perinatal outcome or placental pathology between LGA placentas and appropriate-for-gestational age (AGA) placentas from pregnancies complicated by preGDM. We found LGA placentas are associated with significantly higher neonatal weight but lower fetal-to-placental weight ratio (f/p) for both T1DM and T2DM. T2DM LGA placentas possessed a significantly higher prevalence of placental insufficiency (f/p<10 percentile). Compared to LGA groups, more chronic villitis were seen in the AGA T2DM group, and more acute chorioamnionitis in the T1DM AGA group. No significant differences were seen in maternal BMI or glycemic control. In pregnancies complicated with preGDM, LGA placentas had generally lower placental efficiency than AGA placentas.
研究表明，孕前糖尿病（preGDM）与大于胎龄胎盘（LGA）的较高患病率之间存在关联。然而，LGA胎盘的胎盘病理频率和围产期结局尚不清楚。我们旨在确定LGA胎盘与preGDM合并妊娠的适于胎龄（AGA）胎盘在围产期结局或胎盘病理方面的差异。我们发现，对于1型糖尿病（T1DM）和2型糖尿病（T2DM），LGA胎盘与显著更高的新生儿体重相关，但胎儿与胎盘重量比（f/p）更低。T2DM的LGA胎盘胎盘功能不全的患病率显著更高（f/p<第10百分位数）。与LGA组相比，AGA T2DM组慢性绒毛炎更多，T1DM AGA组急性绒毛膜羊膜炎更多。孕妇BMI或血糖控制方面未见显著差异。在preGDM合并妊娠中，LGA胎盘的胎盘效率通常低于AGA胎盘。
