Placental weight is a valuable indicator of its function, predicting both pregnancy outcome and lifelong health. Population-based centile charts of weight-for-gestational-age and parity are useful for identifying extremes of placental-weight but fail to consider maternal size. To address this deficit a multiple regression model was fitted to derive coefficients for predicting normal placental-weight using records from healthy pregnancies of nulliparous/multiparous women of differing height and weight (n=107,170 deliveries, 37-43weeks gestation). The difference between actual and predicted placental-weight generated a z-score/individual centile for the entire cohort including women with pregnancy complications (n=121,591). The association between maternal BMI and placental-weight extremes defined by the new customised versus population-based standard was investigated by logistic regression, as was the association between low placental-weight and pregnancy complications. Underweight women had a greater risk of low placental-weight [<10thcentile, OR1.84(95%CI 1.66,2.05)] and obese women a greater risk of high placental-weight [>90thcentile, OR1.98(95%CI 1.88,2.10)] using a population-standard. After customisation, the risk of high placental-weight in obese/morbidly-obese women was attenuated [OR1.17(95%CI 1.09,1.25)]/ no longer significant, while their risk of low placental-weight was 59 to 129% higher (P<0.001). The customised placental-weight standard was more closely associated with stillbirth, hypertensive disease, placental abruption and neonatal death than the population standard. Our customised placental-weight standard reveals higher risk of relative placental growth-restriction leading to lower than expected birthweights in obese women, and a stronger association between low placental-weight and pregnancy complications generally. Further, it provides an alternative tool for defining placental-weight extremes with implications for the placental programming of chronic disease.
|Number of pages||10|
|Journal||Journal of Developmental Origins of Health and Disease|
|Early online date||7 Oct 2019|
|Publication status||Published - Aug 2020|
- Placental weight
- body mass index
- customised weight standards
- pregnancy complications
- PRETERM BIRTH
- BODY-MASS INDEX
- PERCENTILE CURVES
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Aberdeen Maternity and Neonatal Databank
Bhattacharya, S. (Data Manager) & Wilde, K. (Supervisor), University of Aberdeen, 1986
http://www.abdn.ac.uk/iahs/research/obsgynae/amnd/overview.php and one more link, http://www.abdn.ac.uk/iahs/research/obsgynae/amnd/access.php (show fewer)