Gestational age impacts birth to placental weight ratio and umbilical cord oxygen values with implications for the fetal oxygen margin of safety

2021 ◽  
pp. 105511
Author(s):  
Bryan S. Richardson ◽  
Barbra de Vrijer ◽  
Hilary K. Brown ◽  
Larry Stitt ◽  
Sheryl Choo ◽  
...  
Keyword(s):  
Umbilical Cord ◽  
Gestational Age ◽  
Weight Ratio ◽  
Placental Weight ◽  
Margin Of Safety

Fetal umbilical cord oxygen values and birth to placental weight ratio in relation to size at birth

2001 ◽  
Vol 185 (3) ◽  
pp. 674-682 ◽  
Author(s):  
Felice Lackman ◽  
Vivian Capewell ◽  
Robert Gagnon ◽  
Bryan Richardson
Keyword(s):  
Umbilical Cord ◽  
Weight Ratio ◽  
Placental Weight ◽  
Size At Birth

scholarly journals Adiponectin Concentration in Umbilical Cord Serum Is Positively Associated with the Weight Ratio of Fetus to Placenta

2006 ◽  
Vol 91 (12) ◽  
pp. 5090-5094 ◽  
Author(s):  
Kozo Kadowaki ◽  
Masako Waguri ◽  
Isao Nakanishi ◽  
Yoshihiro Miyashita ◽  
Masahiro Nakayama ◽  
...  
Keyword(s):  
Umbilical Cord ◽  
Weight Ratio ◽  
Positive Association ◽  
Placental Weight ◽  
Fetal Weight ◽  
Cord Serum ◽  
Igf I ◽  
Design And Methods ◽  
Relationship Of ◽  
The Relationship

Abstract Context: Adiponectin (APN) concentration in umbilical cord serum is higher than that in adult serum. Except for the positive association between birth weight and cord APN concentration, little is known about the pathophysiological function of APN in fetal development. Objective: The objective of this study was to evaluate the relationship of cord serum APN and IGF-I concentrations with the development of the fetoplacental unit. Design and Methods: Umbilical cord serum APN and IGF-I concentrations were measured in term singleton deliveries (n = 94). The association of cord APN and IGF-I concentrations was evaluated in relation to fetal weight, placental weight, and fetoplacental (F/P) weight ratio. Results: Mean concentrations and sd of APN and IGF-I were 36.1 ± 14.0 μg/ml and 58.6 ± 27.0 ng/ml, respectively. Cord APN concentration was positively associated with F/P weight ratio (r = 0.375, P < 0.001) as well as fetal weight (r = 0.389, P < 0.001) but not placental weight. Cord IGF-I concentration was positively associated with fetal weight (r = 0.405, P < 0.001) and placental weight (r = 0.400, P < 0.001) but not F/P weight ratio. In multiregression analysis, only APN concentration resulted in a significant determinant of F/P weight ratio among variables (β = 0.376, P < 0.001). Conclusions: In cord hyperadiponectinemia, fetuses tend to be disproportionately larger for their placental weight and vice versa in cord hypoadiponectinemia. APN is shown to be the first biomarker positively associated with F/P weight ratio.

Gross Placental Structure in a Low-Risk Population of Singleton, Term, First-Born Infants

2009 ◽  
Vol 12 (3) ◽  
pp. 200-210 ◽  
Author(s):  
David A. Coall ◽  
Adrian K. Charles ◽  
Carolyn M. Salafia
Keyword(s):  
Birth Weight ◽  
Surface Area ◽  
Umbilical Cord ◽  
Growth And Development ◽  
Weight Ratio ◽  
Low Risk ◽  
Placental Weight ◽  
Increased Risk ◽  
Umbilical Cord Insertion ◽  
Placental Structure

Suboptimal fetal growth has been associated with an increased risk of adult disease, which may be exacerbated by an increased placental weight–to–fetal weight ratio. Placental weight is a summary measure of placental growth and development throughout pregnancy. However, measures of placental structure, including the chorionic disk surface area and thickness and eccentricity of the umbilical cord insertion, have been shown to account for additional variance in birth weight beyond that explained by placental weight. Little is known of the variability of these placental parameters in low-risk populations; their association with maternal, pregnancy, and neonatal characteristics; and the agreement between manual and digital measures. This study used manual and digital image analysis techniques to examine gross placental anatomy in 513 low-risk, singleton, term, first-born infants. Parametric methods compared groups and examined relationships among variables. Maternal birth weight, prepregnancy weight, and body mass index were associated with increased placental and birth weight (all P < 0.005), but only maternal birth weight was associated with increased placental surface area ( P < 0.0005) and thickness ( P = 0.005). Smoking during pregnancy reduced birth weight and increased the eccentricity of umbilical cord insertion ( P = 0.012 and 0.034, respectively). The variability in these placental parameters was consistently lower than that reported in the literature, and correlations between digital and manual measurements were reasonable ( r = .87–.71). Detailed analyses of gross placental structure can provide biologically relevant information regarding placental growth and development and, potentially, their consequences.

scholarly journals Population-Based Placental Weight Ratio Distributions

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Erin M. Macdonald ◽  
John J. Koval ◽  
Renato Natale ◽  
Timothy Regnault ◽  
M. Karen Campbell
Keyword(s):  
Fetal Growth ◽  
Gestational Age ◽  
Retrospective Cohort ◽  
Weight Ratio ◽  
Population Based ◽  
Placental Weight ◽  
Large For Gestational Age ◽  
Health Indicator ◽  
The Past ◽  
Population Standards

The placental weight ratio (PWR) is a health indicator that reflects the balance between fetal and placental growth. The PWR is defined as the placental weight divided by the birth weight, and it changes across gestation. Its ranges are not well established. We aimed to establish PWR distributions by gestational age and to investigate whether the PWR distributions vary by fetal growth adequacy, small, average, and large for gestational age (SGA, AGA, and LGA). The data came from a hospital based retrospective cohort, using all births at two London, Ontario hospitals in the past 10 years. All women who delivered a live singleton infant between 22 and 42 weeks of gestation were included(n=41441). Nonparametric quantile regression was used to fit the curves. The results demonstrate decreasing PWR and dispersion, with increasing gestational age. A higher proportion of SGA infants have extreme PWRs than AGA and LGA, especially at lower gestational ages. On average, SGA infants had higher PWRs than AGA and LGA infants. The overall curves offer population standards for use in research studies. The curves stratified by fetal growth adequacy are the first of their kind, and they demonstrate that PWR differs for SGA and LGA infants.Corrigendum to “Population-Based Placental Weight Ratio Distributions”

Gestational Age Dependency of Umbilical Cord Serum IL-6 Levels for Detecting Fetal Inflammation

2020 ◽  
Author(s):  
Sota Iwatani ◽  
Takao Kobayashi ◽  
Sachiko Matsui ◽  
Akihiro Hirata ◽  
Miwa Yamamoto ◽  
...  
Keyword(s):  
Umbilical Cord ◽  
Gestational Age ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Significant Negative Correlation ◽  
Cord Serum ◽  
Very Preterm ◽  
Key Points ◽  
Extremely Preterm ◽  
Preterm Newborns

Objective The fetal inflammatory response syndrome (FIRS) is characterized by elevated concentrations of inflammatory cytokines in fetal blood, with preterm delivery and morbidity. Umbilical cord serum interleukin-6 (UC-s-IL-6) is an ideal marker for detecting FIRS. However, the effect of gestational age (GA) on UC-s-IL-6 levels has not been reported. This study aimed to determine the relationship between GA and UC-s-IL-6 levels, and GA-dependent cutoff values of UC-s-IL-6 levels for detecting fetal inflammation. Study Design UC-s-IL-6 concentrations were measured in 194 newborns (44 extremely preterm newborns (EPNs) at 22–27 weeks' GA, 68 very preterm newborns (VPNs) at 28–31 weeks' GA, and 82 preterm newborns (PNs) at 32–34 weeks' GA). Linear regression analyses were used to correlate GA and UC-s-IL-6 levels. Receiver operating characteristic (ROC) curves analyses were performed for detecting the presence of funisitis, as the histopathological counterpart of FIRS. Results A significant negative correlation between GA and UC-s-IL-6 levels was found in newborns with severe funisitis (r s =  − 0.427, p = 0.004) and those with mild funisitis (r s =  − 0.396, p = 0.025). ROC curve analyses revealed the area under the curve for detecting funisitis were 0.856, 0.837, and 0.622 in EPNs, VPNs, and PNs, respectively. The UC-s-IL-6 cutoff value in EPNs (28.1 pg/mL) exceeded those in VPNs and PNs (3.7 and 3.0 pg/mL, respectively). Conclusion UC-s-IL-6 levels were inversely correlated with GA especially in newborns with funisitis. Such GA dependency of UC-s-IL-6 should be considered for detecting fetal inflammation. Key Points

Maternal Marijuana Exposure, Feto-Placental Weight Ratio, and Placental Histology

2020 ◽  
Author(s):  
Torri D. Metz ◽  
Amanda A. Allshouse ◽  
Halit Pinar ◽  
Michael Varner ◽  
Marcela C. Smid ◽  
...  
Keyword(s):  
Tobacco Use ◽  
Fetal Growth ◽  
Statistical Significance ◽  
Weight Ratio ◽  
Marijuana Use ◽  
Placental Weight ◽  
Self Report ◽  
Serum Cotinine ◽  
Fetal Sex ◽  
Live Births

Objective Marijuana use is associated with placenta-mediated adverse pregnancy outcomes including fetal growth restriction, but the mechanism remains uncertain. The objective was to evaluate the association between maternal marijuana use and the feto-placental weight ratio (FPR). Secondarily, we aimed to compare placental histology of women who used marijuana to those who did not. Study Design This was a secondary analysis of singleton pregnancies enrolled in a multicenter and case–control stillbirth study. Prior marijuana use was detected by electronic medical record abstraction or cord homogenate positive for 11-nor-delta-9-tetrahydrocannabinol-9-carboxylic acid. Prior tobacco use was detected by self-report or presence of maternal serum cotinine. Stillbirths and live births were considered separately. The primary outcome was FPR. Association of marijuana use with FPR was estimated with multivariable linear modeling adjusted for fetal sex, preterm birth, and tobacco use. Comparisons between groups for placental histology were made using Chi-square and stratified by live birth and stillbirth, term and preterm deliveries, and fetal sex. Results Of 1,027 participants, 224 were stillbirths and 803 were live births. Overall, 41 (4%) women used marijuana during the pregnancy. The FPR ratio was lower among exposed offspring but reached statistical significance only for term stillbirths (mean 6.84 with marijuana use vs. mean 7.8 without use, p < 0.001). In multivariable modeling, marijuana use was not significantly associated with FPR (p = 0.09). There were no differences in histologic placental features among those with and without marijuana use overall or in stratified analyses. Conclusion Exposure to marijuana may not be associated with FPR. Similarly, there were no placental histologic features associated with marijuana exposure. Further study of the influence of maternal marijuana use on placental development and function is warranted to better understand the association between prenatal marijuana use and poor fetal growth. Key Points

Neonatal Outcomes at Extreme Prematurity by Gestational Age Versus Birth Weight in a Contemporary Cohort

2021 ◽  
Author(s):  
Elizabeth B. Ausbeck ◽  
Phillip Hunter Allman ◽  
Jeff M. Szychowski ◽  
Akila Subramaniam ◽  
Anup Katheria
Keyword(s):  
Birth Weight ◽  
Umbilical Cord ◽  
Gestational Age ◽  
Predictive Value ◽  
Neonatal Death ◽  
Controlled Trial ◽  
Neonatal Morbidity ◽  
Mortality And Morbidity ◽  
Severe Morbidity ◽  
Multicenter Randomized Controlled Trial

Objective The aim of the study is to describe the rates of neonatal death and severe neonatal morbidity in a contemporary cohort, as well as to evaluate the predictive value of birth gestational age (GA) and birth weight, independently and combined, for neonatal mortality and morbidity in the same contemporary cohort. Study Design We performed a secondary analysis of an international, multicenter randomized controlled trial of delayed umbilical cord clamping versus umbilical cord milking in preterm infants born at 23 0/7 to 31 6/7 weeks of gestation. The current analysis was restricted to infants delivered <28 weeks. The primary outcomes of this analysis were neonatal death and a composite of severe neonatal morbidity. Incidence of outcomes was compared by weeks of GA, with planned subanalysis comparing small for gestational age (SGA) versus non-SGA neonates. Multivariable logistic regression was then used to model these outcomes based on birth GA, birth weight, or a combination of both as primary independent predictors to determine which had superior ability to predict outcomes. Results Of 474 neonates in the original trial, 180 (38%) were included in this analysis. Overall, death occurred in 27 (15%) and severe morbidity in 139 (77%) neonates. Rates of mortality and morbidity declined with increasing GA (mortality 54% at 23 vs. 9% at 27 weeks). SGA infants (n = 25) had significantly higher mortality compared with non-SGA infants across all GAs (p < 0.01). There was no difference in the predictive value for neonatal death or severe morbidity between the three prediction options (GA, birth weight, or GA and birth weight). Conclusion Death and severe neonatal morbidity declined with advancing GA, with higher rates of death in SGA infants. Birth GA and birth weight were both good predictors of outcomes; however, combining the two was not more predictive, even in SGA infants. Key Points

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