title: Very low birthweight Infant's placenta and its relation to pregnancy and fetal characteristics.
abstract: Our objective was to relate pathology of the very low birthweight (VLBW) infant's placenta to pregnancy and fetal characteristics. We correlated the pathologic features of 1146 placentas from infants with birth weights of 500-1500 g who were born between 1/1/91 and 12/31/93 to the number of gestations per pregnancy, initiator of preterm delivery, gestational age, birth weight Z score, and duration of rupture of membrane (ROM). Placental correlates of acute inflammation and villous edema were associated with preterm labor (PTL), prelabor premature rupture of membranes (PROM), lower gestational age, and higher birth weight Z score. In PTL pregnancies delivered within 1 h of membrane rupture, 61% of placentas already had membrane inflammation. Placental correlates of pregnancy-induced hypertension (PIH) were seen more commonly with PIH pregnancies, older gestational age, and lower birth weight Z score. We found a more prominent histopathologic signature for singleton than for multiple gestation placentas. The placental pathologic findings associated with the clinical diagnoses of infection, PIH, and low-birth weight Z scores in our VLBW/preterm population are similar to those in the literature regarding term pregnancies. The presence of multiple histologic findings consistent with inflammation in placentas of PTL pregnancies with duration of ROM lasting <1 h suggests that some cases of PTL are precipitated by a more long-standing infection than that previously suspected. Morphologic placental features appear to be correlates of the phenomena leading to premature delivery. Examination of the VLBW infant's placenta provides insight into the etiology and management of VLBW/preterm deliveries.
authors.affiliation: Division of Newborn Medicine, Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA.
authors.forename: A R
authors.initials: AR
authors.lastname: Hansen
authors.forename: M H
authors.initials: MH
authors.lastname: Collins
authors.forename: D
authors.initials: D
authors.lastname: Genest
authors.forename: D
authors.initials: D
authors.lastname: Heller
authors.forename: S
authors.initials: S
authors.lastname: Schwarz
authors.forename: P
authors.initials: P
authors.lastname: Banagon
authors.forename: E N
authors.initials: EN
authors.lastname: Allred
authors.forename: A
authors.initials: A
authors.lastname: Leviton
mesh_terms: D000328:Adult; D001724:Birth Weight; D002821:Chorioamnionitis / Q000150:complications / Q000473:pathology; D005260:Female; D005333:Fetus / Q000473:pathology*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007752:Obstetric Labor, Premature / Q000209:etiology / Q000473:pathology; D010920:Placenta / Q000473:pathology*; D010922:Placenta Diseases / Q000150:complications / Q000473:pathology*; D011225:Pre-Eclampsia / Q000150:complications / Q000473:pathology; D011247:Pregnancy; D011272:Pregnancy, Multiple