Search

Objective: The placenta weight/birthweight (PW/BW) ratio has been shown to be associated with certain long-term fetal outcomes; however, its association with short-term outcomes has not received much attention. Our aim was to assess the correlation between the PW/BW ratio and short-term adverse obstetrics outcomes in full-term, appropriate-for-gestational-age (AGA) newborns., Design: Retrospective cohort study analysis using data from the McGill Obstetrical and Neonatal Database., Setting: McGill University Health Centre in Montreal Canada., Population: AGA neonates., Methods: Three groups of full-term AGA neonates were created, according to their PW/BW ratio (high, normal and low), to be compared. Our primary outcome was the admission rate to the neonatal intensive care unit (NICU), and secondary outcomes included an Apgar score < 7 at 5 minutes, cord PH < 7.0, cord base excess (BE) ≤ 12, respiratory distress syndrome (RDS), patent ductus arteriosus (PDA), occurrence of apnoea episodes, breech presentation at delivery, caesarean section rate and status in discharge home. A logistic regression model was instituted to investigate the predictors for adverse obstetrics outcomes., Main Outcome Measure: Admission to the NICU., Results: Compared with the group with normal PW/BW ratios, the high PW/BW ratio group was associated with increased rates of admission to the NICU, of Apgar scores < 7 at 5 minutes, of breech presentation and caesarean section. On the contrary, the low PW/BW ratio group showed decreased rates of NICU admission, breech presentation and caesarean section., Conclusions: A high PW/BW ratio is significantly correlated with short-term adverse perinatal outcomes. This ratio may be used as a new and simple warning sign to predict the possibility of short-term health risks for newborns., (© 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.)

Background: Numerous studies correlated maternal serum and fetal cord Leptin Levels in pregnancy with new born weight (NBW) and maternal body mass index (BMI). However, there are only a few published studies concerning amniotic fluid leptin and its possible relationship to fetal growth and NBW., Objectives: To correlate leptin and insulin in amniotic fluid and maternal serum collected at 16-20 gestational weeks to NBW., Methods: This was an observational study in which maternal serum Leptin, insulin, and amniotic fluid Leptin and insulin, studied from 70 healthy pregnant women undergoing amniocentesis for karyotyping, at 16-20 weeks gestation. NBW was correlated with maternal BMI and leptin and insulin Levels in maternal serum and amniotic fluid., Results: Maternal serum leptin was detected as the best predictor of NBW. Squared correlation coefficient, r2 = 0.09, was statistically significant (P < 0.01). Maternal BMI correlated significantly with serum Levels of insulin and leptin r2 = 0.16 and 0.27 respectively, P < 0.01., Conclusion: In normal pregnancies, amniotic fluid Leptin correlates partially with NBW. Maternal serum leptin correlates significantly with NBW.

Please cite this paper as: Shehata F, Levin I, Shrim A, Ata B, Weisz B, Gamzu R, Almog B. Placenta/birthweight ratio and perinatal outcome: a retrospective cohort analysis. BJOG 2011;118:741-747. The placenta weight/birthweight (PW/BW) ratio has been shown to be associated with certain long-term fetal outcomes; however, its association with short-term outcomes has not received much attention. Our aim was to assess the correlation between the PW/BW ratio and short-term adverse obstetrics outcomes in full-term, appropriate-for-gestational-age (AGA) newborns. Retrospective cohort study analysis using data from the McGill Obstetrical and Neonatal Database. McGill University Health Centre in Montreal Canada. AGA neonates. Three groups of full-term AGA neonates were created, according to their PW/BW ratio (high, normal and low), to be compared. Our primary outcome was the admission rate to the neonatal intensive care unit (NICU), and secondary outcomes included an Apgar score < 7 at 5 minutes, cord PH < 7.0, cord base excess (BE) ≤ 12, respiratory distress syndrome (RDS), patent ductus arteriosus (PDA), occurrence of apnoea episodes, breech presentation at delivery, caesarean section rate and status in discharge home. A logistic regression model was instituted to investigate the predictors for adverse obstetrics outcomes. Admission to the NICU. Compared with the group with normal PW/BW ratios, the high PW/BW ratio group was associated with increased rates of admission to the NICU, of Apgar scores < 7 at 5 minutes, of breech presentation and caesarean section. On the contrary, the low PW/BW ratio group showed decreased rates of NICU admission, breech presentation and caesarean section. A high PW/BW ratio is significantly correlated with short-term adverse perinatal outcomes. This ratio may be used as a new and simple warning sign to predict the possibility of short-term health risks for newborns. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To establish updated placental percentile nomograms in a large North American population for singleton and twin gestations for the use of researchers and clinicians. Study design: Data was extracted from our computerized registry; McGill Obstetrics and Neonatal Database (MOND). The registry includes all the obstetrical data on all deliveries at the McGillUniversity, including placental weight, placental pathologies, maternal and perinatal complications. 20,635 singleton deliveries and 527 twin deliveries were included. Placental weight, gestational age at delivery, birth weight and gender were retrieved. Tables and figures for the3rd,10th,25th, 50th, 75th 90th, and 97th percentile of placental weight by gestational age, placental weight by birth weight and placental to birth weight ratio by gestational age were produced. Results: Tables and figures are presented for placental percentiles curves according to gestational age, gestational weight and gender for singleton and twin deliveries. In addition, tables and figures are presented for the ratio of placental weight to birth weight. Conclusions: Population percentile curves have been produced for placental weight and for the ratio of placental weight to birth weight to for singleton and twin deliveries. [Copyright &y& Elsevier]

A response by F. Shehata and colleagues to a letter to the editor about their article "Placenta/birthweight ratio and perinatal outcome: a retrospective cohort analysis," in the 2011 issue is presented.