title: Do placental lesions among term small for gestational age newborns differ according to the clinical presentation?
abstract: OBJECTIVE
  To examine the incidence of placental lesions among women who delivered isolated small for gestational age newborns (isolated-SGA) at term compared to placentas from non-isolated-SGA born at term, early SGA and appropriate for age newborns (AGA).
  
  
  METHODS
  A case-control study conducted at a university teaching hospital. Placentas of women who delivered a newborn with a birthweight less than the 10th percentile were included. Group A (study group): isolated-SGA delivered at term. Group B (1st control group): Term SGA accompanied antepartum with oligohydramnios or maternal hypertension (non-isolated-SGA). Group C (2nd control group): early SGA delivered before 34 weeks. Group D (3rd control group): placentas of low risk women who delivered AGA newborns at term. A total of 307 placentas were included: 72, 81, 60 and 94 placentas from Groups A, B, C, and D respectively. The primary outcome was the incidence of placental lesions that characterize SGA.
  
  
  RESULTS
  The most frequent placental lesion found among all groups was maternal obstructive lesions, which appeared in 45.8% and 45.7% of placentas from groups A and B respectively (p=0.98). The incidence among group A was significantly higher than in group D (20.2%) (p=0.0006) and lower than in group C (76.7%) (p=0.0004). The incidence of any placental lesion that characterized SGA among group A (69.4%) was 7.9 times higher than in group D (22.3%) (p<0.0001) and comparable to group B (61.7%) (p=0.3). The incidence of any placental lesion was highest among group C (83.3%).
  
  
  CONCLUSIONS
  The incidence of placental lesions was comparable among term SGA regardless of whether isolated or not and significantly higher than among AGA newborns.
authors: Rappaport Faculty of Medicine, Technion, Haifa, Israel; Department of Obstetrics and Gynecology, Emek Medical Center, Afula, Israel. Electronic address: salim_ra@clalit.org.il.
authors: Raed
authors: R
authors: Salim
authors: Rappaport Faculty of Medicine, Technion, Haifa, Israel.
authors: Jumana
authors: J
authors: Jubran
authors: Department of Pathology, Emek Medical Center, Afula, Israel.
authors: Marina
authors: M
authors: Okopnik
authors: Rappaport Faculty of Medicine, Technion, Haifa, Israel; Department of Obstetrics and Gynecology, Emek Medical Center, Afula, Israel.
authors: Gali
authors: G
authors: Garmi
mesh_terms: D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D010920:Placenta / Q000473:pathology*; D010922:Placenta Diseases / Q000453:epidemiology* / Q000473:pathology; D011247:Pregnancy
keywords: Fetal growth restriction; Hypertension; Oligohydramnios; Placental histopathological lesions; Small for gestational age