title: Association between placental morphology and childhood systolic blood pressure.
abstract: We tested hypotheses that disproportionately large placental size and vascular lesions were associated with high systolic blood pressure (SBP); and these associations might be more evident with age. The sample included 13 273 of 40 666 full-term singletons in the Collaborative Perinatal Project. Placentas were examined by pathologists blinded of pregnancy courses and outcomes. The 4-month and 7-year SBPs were measured with palpation and auscultation methods, respectively. We found that placental weight (adjusted mean difference corresponding to an increase by 1 SD 0.50 [95% CI, 0.33 to 0.68]) and placenta-fetus weight ratio (0.37 [95% CI, 0.19 to 0.54]) was positively associated with 7-year SBP but not associated with 4-month SBP. Placental largest and smallest diameters and area were negatively associated with 4-month SBP but positively with 7-year SBP. Placental thickness was negatively associated with 4-month SBP only. Placental volume was negatively associated with 4-month SBP (-0.60 [95% CI, - 0.85 to -0.35]) but positively associated with 7-year SBP (0.48 [95% CI, 0.30 to 0.67]). Thrombi in cord vessels (adjusted mean difference versus absence 2.73 [95% CI, - 0.03 to 5.50]) and decidual vessels (2.58 [95% CI, 0.24 to 4.91]), villous microinfarcts (1.63 [95% CI, 0.71 to 2.55]), necrosis at the decidual margin (1.57 [95% CI, 0.54 to 2.59]), and basalis (3.44 [95% CI, 1.55 to 5.32]) were associated with higher 4-month SBP only. We conclude that placental inefficiency, reflected by disproportionately large weight and size, predicts long-term blood pressure, whereas vascular resistance and lesions may only influence short-term blood pressure.
authors.affiliation: Epidemiology Section, Department of Community Health, Brown University, Second Floor, Providence, RI 02912, USA. xiaozhongwen@hotmail.com
authors.forename: Xiaozhong
authors.initials: X
authors.lastname: Wen
authors.forename: Elizabeth W
authors.initials: EW
authors.lastname: Triche
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Hogan
authors.forename: Edmond D
authors.initials: ED
authors.lastname: Shenassa
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Buka
mesh_terms: D001724:Birth Weight; D001794:Blood Pressure; D002648:Child; D015331:Cohort Studies; D005260:Female; D005333:Fetus / Q000098:blood supply / Q000503:physiopathology; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D007223:Infant; D008297:Male; D009929:Organ Size; D010920:Placenta / Q000473:pathology*; D010927:Placental Insufficiency / Q000473:pathology*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D013927:Thrombosis / Q000453:epidemiology / Q000503:physiopathology