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妊娠高血压综合征母亲所生小于胎龄早产新生儿的胎盘形态学特征

Placental morphological features of small for gestational age preterm neonates born to mothers with pregnancy-induced hypertension.

作者信息

Zhang Yu, Zeng Hui-Hui

机构信息

Department of Neonatal Intensive Care Unit, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China.

出版信息

Front Pediatr. 2023 Mar 21;11:1093622. doi: 10.3389/fped.2023.1093622. eCollection 2023.

Abstract

INTRODUCTION

Small for gestational age (SGA) neonates are often born to mothers with pregnancy-induced hypertension (PIH). Here, we aimed to explore the morphometric characteristics of the placenta during the perinatal period associated with SGA risk in mothers with PIH and identify the risk factors related to SGA.

METHODS

The medical records of 134 neonates born between 28- and 32-weeks' gestation to PIH mothers were retrospectively analyzed. Placental morphology and umbilical cord (UC) length were compared between the SGA and appropriate for gestational age (AGA) groups.

RESULTS

The placenta of the SGA group had a shorter major (15.00 vs. 18.00 cm;  = -6.04, < 0.01) and minor placenta axes (13.00 vs. 15.00 cm;  = -4.59, < 0.01), lower weight (300.00 vs. 420.00 g;  = -7.21, < 0.01), smaller volume (282.00 vs. 396.00 cm;  = -5.00, < 0.01), and smaller area (141.00 vs. 212.00 cm;  = -5.96, < 0.01) than the AGA group. The UC was significantly shorter (39.00 vs. 44.00 cm;  = -3.68,  < 0.01). Short placental major axis [= 0.03; odds ratio (OR): 2.16; 95% confidence interval (CI): 1.84 - 2.63] and low placental weight (< 0.01; OR: 2.68; 95% CI: 2.66 - 2.70) were independent risk factors for SGA in premature newborns of PIH mothers.

DISCUSSION

A major axis shorter than 15.5 cm or placental weight lower than 347.50 g at birth was related to a greater risk of SGA infants born to PIH mothers. As a predictor in prenatal ultrasound, the major axis is more helpful for precise prenatal pre-evaluation of vulnerable SGA preterm neonates with PIH mothers.

摘要

引言

小于胎龄(SGA)新生儿的母亲常患有妊娠高血压(PIH)。在此,我们旨在探讨围产期胎盘的形态特征与PIH母亲SGA风险之间的关系,并确定与SGA相关的风险因素。

方法

回顾性分析134例孕28至32周出生的PIH母亲所生新生儿的病历。比较SGA组和适于胎龄(AGA)组的胎盘形态和脐带(UC)长度。

结果

SGA组胎盘的长径(15.00 vs. 18.00 cm;=-6.04,<0.01)和短径(13.00 vs. 15.00 cm;=-4.59,<0.01)较短,重量较轻(300.00 vs. 420.00 g;=-7.21,<0.01),体积较小(282.00 vs. 396.00 cm;=-5.00,<0.01),面积较小(141.00 vs. 212.00 cm;=-5.96,<0.01)。UC明显较短(39.00 vs. 44.00 cm;=-3.68,<0.01)。胎盘长径短[=0.03;比值比(OR):2.16;95%置信区间(CI):1.84-2.63]和胎盘重量低(<0.01;OR:2.68;95%CI:2.66-2.70)是PIH母亲早产新生儿SGA的独立危险因素。

讨论

出生时胎盘长径短于15.5 cm或胎盘重量低于347.50 g与PIH母亲所生SGA婴儿的风险增加有关。作为产前超声的预测指标,长径对于PIH母亲的脆弱SGA早产新生儿的精确产前预评估更有帮助。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f4f/10070738/41f56a30fa75/fped-11-1093622-g001.jpg

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