title: The effect of placenta previa on fetal growth and pregnancy outcome, in correlation with placental pathology.
abstract: To compare the clinical characteristics and placental histopathology between pregnancies complicated by placenta previa and controls.
  
  
  
  Between 2009 and 2015, cesarean deliveries (CDs) of 119 pregnancies with placenta previa were identified from which maternal outcomes, neonatal outcomes and placental pathology were reviewed. Results were compared with CDs matched for maternal age and pregnancy complications (control group, n=119). Placental lesions were classified into maternal and fetal vascular supply lesions and inflammatory response. Composite neonatal outcome was defined as one or more of early neonatal complications. Small-for-gestational age (SGA) was defined as birth weight ⩽10th percentile.
  
  
  
  Placentas from the previa group had higher rates of weights <10th percentile (P<0.001) and of maternal and fetal vascular supply lesions (P<0.001, for both). Higher rate of SGA (P=0.003) and worse composite neonatal outcome (P<0.001) were also observed in the previa group as compared with controls. After controlling for potential confounding bias using multivariable logistic regression models, placenta previa remained statistically significantly associated with placental maternal (adjusted odds ratio (aOR) 2.48, 95% confidence interval (CI) 1.2-4.9, P=0.009) and fetal (aOR 7.05, 95% CI 2.4-20.2, P<0.001) vascular supply lesions, SGA (aOR 10, 95% CI 2.3-44.2, P=0.002) and adverse neonatal outcome (aOR 6.87, 95% CI 2.9-11.8, P<0.001).
  
  
  
  More placental vascular supply lesions, higher rate of SGA and worse neonatal outcome characterized pregnancies with placenta previa in the current study. These findings may suggest that abnormal placentation is accompanied by suboptimal implantation that interferes with fetal growth.
authors: Department of Obstetrics and Gynecology, The Edith Wolfson Medical Center, Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Holon, Israel.
authors: E
authors: E
authors: Weiner
authors: Department of Obstetrics and Gynecology, The Edith Wolfson Medical Center, Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Holon, Israel.
authors: H
authors: H
authors: Miremberg
authors: Department of Obstetrics and Gynecology, The Edith Wolfson Medical Center, Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Holon, Israel.
authors: E
authors: E
authors: Grinstein
authors: Department of Obstetrics and Gynecology, The Edith Wolfson Medical Center, Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Holon, Israel.
authors: Y
authors: Y
authors: Mizrachi
authors: Department of Pathology, The Edith Wolfson Medical Center, Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Holon, Israel.
authors: L
authors: L
authors: Schreiber
authors: Department of Obstetrics and Gynecology, The Edith Wolfson Medical Center, Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Holon, Israel.
authors: J
authors: J
authors: Bar
authors: Department of Obstetrics and Gynecology, The Edith Wolfson Medical Center, Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Holon, Israel.
authors: M
authors: M
authors: Kovo
mesh_terms: D000328:Adult; D001724:Birth Weight; D016022:Case-Control Studies; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D047109:Fetal Development / Q000502:physiology*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007902:Length of Stay / Q000706:statistics & numerical data; D009929:Organ Size; D010920:Placenta / Q000473:pathology*; D010923:Placenta Previa; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors