Department of Obstetrics and Gynecology, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy.
Pathology Unit, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy.
Placenta. 2024 Feb;146:9-16. doi: 10.1016/j.placenta.2023.12.021. Epub 2023 Dec 22.
The study of the macroscopic appearance of the placenta may represent a useful tool to understand the pathophysiology of adverse pregnancy outcomes. The aim of this study was to evaluate biometry and morphology of placentas in relation to maternal, neonatal and pregnancy course characteristics.
Clinical and placental data (biometry and macroscopic features of chorionic disk and adnexa) from unselected consecutive singleton pregnancies were recorded at the same Institution. Placental efficiency was approximated as ratio between fetal and placental weight (FPR). The total population was grouped according to the presence of any maternal comorbidity or pregnancy complication (group 1), neonatal complications diagnosed only at birth (2) and absence of any comorbidity (3). Multi-adjusted general linear and logistic regression models were performed to analyze associations between groups and placental biometry and morphology.
The study population counted 1008 pregnancies: 576 (57.2 %) classified as group 1, 76 (7.5 %) as group 2 and 356 (35.3 %) uncomplicated controls (group 3). In multivariate models adjusted for confounding factors, no significant differences in placental biometry and macroscopic features were observed among the three groups. Maternal BMI was significantly associated with higher placental and birth weight and lower FPR; moreover FPR was significantly higher in pregnancies carrying males compared to female neonates.
Maternal comorbidity or pregnancy disease was not associated with significant changes in placental macroscopic biometry and morphology. Conversely, maternal pregestational BMI and fetal sex impact on placental biometry and efficiency, suggesting different intrauterine adaptations in obese mothers and in male and female fetuses.
胎盘的宏观外观研究可能代表了理解不良妊娠结局病理生理学的有用工具。本研究的目的是评估胎盘的生物计量学和形态与母体、新生儿和妊娠过程特征的关系。
在同一机构记录了未经选择的连续单胎妊娠的临床和胎盘数据（生物计量学和绒毛膜盘和附属物的宏观特征）。胎盘效率近似为胎儿与胎盘重量的比值（FPR）。根据是否存在任何母体合并症或妊娠并发症（第 1 组）、仅在出生时诊断出的新生儿并发症（第 2 组）和无任何合并症（第 3 组）将总人群分组。进行多调整的一般线性和逻辑回归模型分析各组与胎盘生物计量学和形态之间的关联。
研究人群包括 1008 例妊娠：576 例（57.2%）归类为第 1 组，76 例（7.5%）为第 2 组，356 例（35.3%）为无并发症对照组（第 3 组）。在调整混杂因素的多变量模型中，三组之间的胎盘生物计量学和宏观特征无显著差异。母体 BMI 与较高的胎盘和出生体重以及较低的 FPR 显著相关；此外，与女性新生儿相比，携带男性胎儿的妊娠 FPR 显著升高。
母体合并症或妊娠疾病与胎盘宏观生物计量学和形态无显著变化相关。相反，母体孕前 BMI 和胎儿性别对胎盘生物计量学和效率有影响，提示肥胖母亲和男性和女性胎儿的宫内适应不同。
