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与胎儿生长受限及随后的新生儿结局相关的胎盘病理改变。

Placental Pathologic Changes Associated with Fetal Growth Restriction and Consequent Neonatal Outcomes.

机构信息

Department of Obstetrics and Gynecology, Inje University Busan Paik Hospital, Busan, Korea (the Republic of).

Paik Inje Memorial Institute for Clinical Medicine Research, Pusan, Korea (the Republic of).

出版信息

Fetal Pediatr Pathol. 2021 Oct;40(5):430-441. doi: 10.1080/15513815.2020.1723147. Epub 2020 Feb 14.

Abstract

To evaluate the pathological changes of the placenta to determine the mechanism underlying placenta-derived fetal growth restriction (FGR) and investigate its influence on neonatal outcomes. This retrospective case-control study included 120 singleton pregnancies with FGR as well as 120 gestational age-matched controls. We compared the placental pathological findings and neonatal outcomes according to the presence of placental malperfusion. The FGR group demonstrated lower placental weight (350.8 ± 118.8 vs. 436.1 ± 109.7g, P < .0001), smaller chorionic plate area (157.7 ± 48.0 vs. 201.5 ± 53.4 cm, P < .0001), and higher rate of villous change lesions (84.2% vs. 52.5%, P < .0001) than the control group. FGR neonates with placental malperfusion had a higher rate of adverse neonatal outcomes (87.1% vs. 63.2%, P = .0175). Small placentas and placental malperfusion reflected in villous changes are associated with FGR. FGR neonates with placental malperfusion are more susceptible to adverse neonatal outcomes.

摘要

目的

评估胎盘的病理变化,以确定胎盘源性胎儿生长受限(FGR)的发病机制,并探讨其对新生儿结局的影响。

方法

本回顾性病例对照研究纳入了 120 例 FGR 单胎妊娠病例和 120 例同期的胎盘病理检查结果相匹配的对照病例。根据胎盘灌注不良的发生情况,比较了胎盘病理发现和新生儿结局。

结果

FGR 组的胎盘重量(350.8±118.8 比 436.1±109.7g,P<0.0001)、绒毛板面积(157.7±48.0 比 201.5±53.4cm,P<0.0001)和绒毛病变发生率(84.2%比 52.5%,P<0.0001)均低于对照组。胎盘灌注不良的 FGR 新生儿不良新生儿结局发生率更高(87.1%比 63.2%,P=0.0175)。

结论

小胎盘和绒毛病变反映的胎盘灌注不良与 FGR 有关。胎盘灌注不良的 FGR 新生儿更易发生不良新生儿结局。

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