Alikhani Fariba, Aalinezhad Marzieh, Bahrami Mahshid, Geravandi Mahsa
Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
BMC Pregnancy Childbirth. 2024 Dec 20;24(1):835. doi: 10.1186/s12884-024-07050-5.
Preeclampsia is one of the complications of pregnancy with uncertain etiology. Nevertheless, it is believed that the condition may arise due to abnormal trophoblastic invasion, resulting in vascular remodeling and increased resistance in the spiral arteries. It is assumed that the location of the placenta might have contributed to the formation of trophoblastic invasion and further placental supply. The current study aims to investigate the association of placental location with the incidence of preeclampsia.
The current case-control study was conducted on 206 primigravid pregnant woman undergone routine screening ultrasonography study between 14 and 26 gestational weeks to determine the location of the placenta (anterior, posterior, or lateral). The pregnant women were categorized as cases that met the criteria of high-risk for preeclampsia (n = 106) or the controls (n = 100).
Logistic regression analysis identified increased age (OR: 1.047, 95% CI: 1.02-1.07, PPP-value = 0.033), BMI > 25 kg/m² (OR: 4.61, 95% CI: 1.02-10.02, PPP-value = 0.038), and anterior placental location (OR: 2.79, 95% CI: 1.08-9.43, PPP-value = 0.038) as significant predictors of preeclampsia. Posterior placental location was initially associated with preeclampsia (PPP-value = 0.049), but this association was not robust and may reflect random variation.
This study identified anterior placental location, increased maternal age, and BMI above 25 kg/m² as significant predictors of preeclampsia. These findings suggest that healthcare providers should closely monitor pregnant women with anteriorly located placentas, advanced age, or elevated BMI. Regular blood pressure monitoring and urine protein screening for individuals with anterior placental location could facilitate early diagnosis and management of preeclampsia. While posterior placental location showed a potential association, it was less consistent, and further research is needed to confirm its role.
子痫前期是妊娠期并发症之一,病因尚不明确。然而,人们认为该病症可能是由于滋养细胞浸润异常导致血管重塑以及螺旋动脉阻力增加所致。据推测,胎盘的位置可能对滋养细胞浸润的形成及进一步的胎盘供应有影响。本研究旨在探讨胎盘位置与子痫前期发病率之间的关联。
本病例对照研究对206例初孕妇进行了研究,这些孕妇在妊娠14至26周期间接受了常规超声筛查以确定胎盘位置(前位、后位或侧位)。将孕妇分为符合子痫前期高危标准的病例组(n = 106)和对照组(n = 100)。
逻辑回归分析确定年龄增加(比值比:1.047,95%置信区间:1.02 - 1.07,P值 = 0.033)、体重指数>25 kg/m²(比值比:4.61,95%置信区间:1.02 - 10.02,P值 = 0.038)以及胎盘前位(比值比:2.79,95%置信区间:1.08 - 9.43,P值 = 0.038)是子痫前期的显著预测因素。胎盘后位最初与子痫前期相关(P值 = 0.049),但这种关联并不稳健,可能反映的是随机变异。
本研究确定胎盘前位、孕妇年龄增加以及体重指数高于25 kg/m²是子痫前期的显著预测因素。这些发现表明,医疗保健人员应密切监测胎盘前位、年龄较大或体重指数升高的孕妇。对胎盘前位的个体进行定期血压监测和尿蛋白筛查有助于子痫前期的早期诊断和管理。虽然胎盘后位显示出潜在关联,但不太一致,需要进一步研究以确认其作用。