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Stillbirths at Term: Case Control Study of Risk Factors, Growth Status and Placental Histology
OBJECTIVE: To investigate the proportion of stillbirths at term associated with abnormal growth using customized birth weight percentiles and to compare histological placental findings both in underweight stillborn fetuses and in live births. METHODS: A retrospective case-control study of 150 single...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5147826/ https://www.ncbi.nlm.nih.gov/pubmed/27936018 http://dx.doi.org/10.1371/journal.pone.0166514 |
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author | Mecacci, Federico Serena, Caterina Avagliano, Laura Cozzolino, Mauro Baroni, Eleonora Rambaldi, Marianna Pina Simeone, Serena Castiglione, Francesca Taddei, Gian Luigi Bulfamante, Gaetano |
author_facet | Mecacci, Federico Serena, Caterina Avagliano, Laura Cozzolino, Mauro Baroni, Eleonora Rambaldi, Marianna Pina Simeone, Serena Castiglione, Francesca Taddei, Gian Luigi Bulfamante, Gaetano |
author_sort | Mecacci, Federico |
collection | PubMed |
description | OBJECTIVE: To investigate the proportion of stillbirths at term associated with abnormal growth using customized birth weight percentiles and to compare histological placental findings both in underweight stillborn fetuses and in live births. METHODS: A retrospective case-control study of 150 singleton term stillbirths. The livebirth control groups included 586 cases of low-risk pregnancies and 153 late fetal growth restriction fetuses. Stillbirths and livebirths from low-risk pregnancies were classified using customized standards for fetal weight at birth, as adequate for gestational age (AGA; 10-90(th) percentile), small (SGA; <10(th) percentile) or large for gestational age (LGA; >90(th) percentile). Placental characteristics in stillbirth were compared with those from livebirths using four categories: inflammation, disruptive, obstructive and adaptive lesions. RESULTS: There was a higher rate of SGA (26% vs 6%, p<0.001) and LGA fetuses (10.6% vs 5.6%, p<0.05) in the stillbirth group. Among stillbirth fetuses, almost half of the SGA were very low birthweight (≤3°percentile) (12% vs 0.3%, p<0.001). The disruptive (7.3% vs 0.17%;p<0.001), obstructive (54.6% vs 7.5%;p<0.001) and adaptive (46.6% vs 35.8%;p<0.001) findings were significantly more common in than in livebirth-low risk. Placental characteristics of AGA and SGA stillbirth were compared with those of AGA and FGR livebirth. In stillbirths-SGA we found a higher number of disruptive (12.8% vs 0%; p<0.001), obstructive (58.9% vs 23.5%;p<0.001) and adaptive lesions (56.4% vs 49%; p 0.47) than in livebirth-FGR. CONCLUSION: The assessment of fetal weight with customized curves can identify fetuses which have not reached their genetically determined growth potential and are therefore at risk for adverse outcomes. Placental evaluation in stillbirths can reveal chronic histological signs that might be useful to clinical assessment, especially in underweight fetuses. |
format | Online Article Text |
id | pubmed-5147826 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-51478262016-12-28 Stillbirths at Term: Case Control Study of Risk Factors, Growth Status and Placental Histology Mecacci, Federico Serena, Caterina Avagliano, Laura Cozzolino, Mauro Baroni, Eleonora Rambaldi, Marianna Pina Simeone, Serena Castiglione, Francesca Taddei, Gian Luigi Bulfamante, Gaetano PLoS One Research Article OBJECTIVE: To investigate the proportion of stillbirths at term associated with abnormal growth using customized birth weight percentiles and to compare histological placental findings both in underweight stillborn fetuses and in live births. METHODS: A retrospective case-control study of 150 singleton term stillbirths. The livebirth control groups included 586 cases of low-risk pregnancies and 153 late fetal growth restriction fetuses. Stillbirths and livebirths from low-risk pregnancies were classified using customized standards for fetal weight at birth, as adequate for gestational age (AGA; 10-90(th) percentile), small (SGA; <10(th) percentile) or large for gestational age (LGA; >90(th) percentile). Placental characteristics in stillbirth were compared with those from livebirths using four categories: inflammation, disruptive, obstructive and adaptive lesions. RESULTS: There was a higher rate of SGA (26% vs 6%, p<0.001) and LGA fetuses (10.6% vs 5.6%, p<0.05) in the stillbirth group. Among stillbirth fetuses, almost half of the SGA were very low birthweight (≤3°percentile) (12% vs 0.3%, p<0.001). The disruptive (7.3% vs 0.17%;p<0.001), obstructive (54.6% vs 7.5%;p<0.001) and adaptive (46.6% vs 35.8%;p<0.001) findings were significantly more common in than in livebirth-low risk. Placental characteristics of AGA and SGA stillbirth were compared with those of AGA and FGR livebirth. In stillbirths-SGA we found a higher number of disruptive (12.8% vs 0%; p<0.001), obstructive (58.9% vs 23.5%;p<0.001) and adaptive lesions (56.4% vs 49%; p 0.47) than in livebirth-FGR. CONCLUSION: The assessment of fetal weight with customized curves can identify fetuses which have not reached their genetically determined growth potential and are therefore at risk for adverse outcomes. Placental evaluation in stillbirths can reveal chronic histological signs that might be useful to clinical assessment, especially in underweight fetuses. Public Library of Science 2016-12-09 /pmc/articles/PMC5147826/ /pubmed/27936018 http://dx.doi.org/10.1371/journal.pone.0166514 Text en © 2016 Mecacci et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Mecacci, Federico Serena, Caterina Avagliano, Laura Cozzolino, Mauro Baroni, Eleonora Rambaldi, Marianna Pina Simeone, Serena Castiglione, Francesca Taddei, Gian Luigi Bulfamante, Gaetano Stillbirths at Term: Case Control Study of Risk Factors, Growth Status and Placental Histology |
title | Stillbirths at Term: Case Control Study of Risk Factors, Growth Status and Placental Histology |
title_full | Stillbirths at Term: Case Control Study of Risk Factors, Growth Status and Placental Histology |
title_fullStr | Stillbirths at Term: Case Control Study of Risk Factors, Growth Status and Placental Histology |
title_full_unstemmed | Stillbirths at Term: Case Control Study of Risk Factors, Growth Status and Placental Histology |
title_short | Stillbirths at Term: Case Control Study of Risk Factors, Growth Status and Placental Histology |
title_sort | stillbirths at term: case control study of risk factors, growth status and placental histology |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5147826/ https://www.ncbi.nlm.nih.gov/pubmed/27936018 http://dx.doi.org/10.1371/journal.pone.0166514 |
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