Placental abruption and placental weight - implications for fetal growth

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

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773: Low molecular weight heparin (LMWH) versus no treatment in women with previous severe preeclampsia, fetal growth restrictin, severe placental abruption, stillbirth and placental findings without thrombophilia

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2009.10.790 ◽

2009 ◽

Vol 201 (6) ◽

pp. S278

Author(s):

Michael Kupferminc ◽

Eliyahu Rimon ◽

Sharon Malovitz ◽

Joseph B. Lessing ◽

David Pausner ◽

...

Keyword(s):

Molecular Weight ◽

Fetal Growth ◽

Low Molecular Weight Heparin ◽

Placental Abruption ◽

Severe Preeclampsia ◽

Low Molecular Weight

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The complex inter-relationship of preterm birth, fetal growth, and infant mortality in twin gestations: The effect of placental abruption

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2004.10.305 ◽

2004 ◽

Vol 191 (6) ◽

pp. S117

Author(s):

Cande Ananth ◽

Neela Srinivas ◽

John Smulian

Keyword(s):

Preterm Birth ◽

Infant Mortality ◽

Fetal Growth ◽

Placental Abruption ◽

Relationship Of

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Leptin Concentrations in Maternal and Umbilical Cord Blood in Relation to Maternal Weight, Birth Weight and Weight of the Placenta

Bangladesh Journal of Obstetrics & Gynaecology ◽

10.3329/bjog.v23i1.3049 ◽

1970 ◽

Vol 23 (1) ◽

pp. 3-7 ◽

Cited By ~ 1

Author(s):

S Ishrat ◽

MW Rahman ◽

MR Rahman ◽

MZ Hussain ◽

S Jahan

Keyword(s):

Birth Weight ◽

Cord Blood ◽

Fetal Growth ◽

Leptin Receptor ◽

Venous Blood ◽

The Body ◽

Placental Weight ◽

Enzyme Linked Immunosorbent Assay ◽

Maternal Weight ◽

Serum Leptin

Objective: Leptin is a hormone which regulates adipose tissue mass of the body. Substantial increase of leptin during pregnancy and detection of leptin and leptin receptor in placenta have led to the speculation that leptin is a gestational hormone with a possible role in regulation of fetal growth. The study was done to find out whether maternal and cord blood leptin correlate with birthweight and weight of the placenta. Materials and methods: A prospective cross sectional study was undertaken in the Department of Obsterics and Gynecology, Bangabandhu Sheikh Mujib Medical University from January 2005 to June 2005. The study was carried out on 39 pairs of mothers and newborns. Maternal venous blood was sampled just before delivery. Cord blood was obtained, birth weight and placental weight measurements were taken just after delivery of the baby. Serum leptin levels were measured by enzyme linked immunosorbent assay. Results: Maternal serum leptin was 24.50 ng/ml (range- 13.15-45.60 ng/ml) and cord serum leptin was 6.50 ng/ml (range- 2.02-12.30 ng/ml). There was no correlation between maternal leptin and birth weight or between maternal leptin and placental weight. Cord leptin was significantly correlated with birth weight but not with placental weight. There was no correlation between maternal and cord blood leptin. There was no significant gender differences in cord blood leptin concentrations. Conclusions: There may be an important role of leptin in regulation of fetal growth and development. Placenta may not be a major source of leptin in maternal and feto-placental circulation. Maternal leptin cannot be a reliable marker of fetal growth. Keywords: Serum leptin, birth weight, placental weight doi: 10.3329/bjog.v23i1.3049 Bangladesh J Obstet Gynaecol, 2008; Vol. 23(1) : 3-7

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Fetal growth and ratio of placental weight to birth weight.

BMJ ◽

10.1136/bmj.304.6827.638-a ◽

1992 ◽

Vol 304 (6827) ◽

pp. 638-638 ◽

Cited By ~ 5

Author(s):

R. De Courcy-Wheeler ◽

C. Wolfe

Keyword(s):

Birth Weight ◽

Fetal Growth ◽

Placental Weight

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273.Insulin-like growth factor treatment of pregnant guinea pigs during early pregnancy promotes fetal growth

Reproduction Fertility and Development ◽

10.1071/srb04abs273 ◽

2004 ◽

Vol 16 (9) ◽

pp. 273

Author(s):

A. N. Sferruzzi-Perri ◽

J. A. Owens ◽

J. S. Robinson ◽

C. T. Roberts

Keyword(s):

Growth Factor ◽

Fetal Growth ◽

Early Pregnancy ◽

Guinea Pigs ◽

Placental Weight ◽

Fetal Weight ◽

Abdominal Circumference ◽

Insulin Like Growth Factor ◽

Crown Rump Length ◽

Igf I

Insulin-like growth factor (IGF)-II is an important regulator of growth in many tissues and is abundantly expressed in the placenta during pregnancy. Gene ablation studies performed in mice have shown that IGF-II deficiency results in both impaired fetal and placental growth, whereas deficiency in IGF-I reduces fetal growth only. Conversely, maternal IGF supplementation in early pregnancy in the guinea pig increases placental and fetal size by mid pregnancy. This study aimed to determine whether these anabolic effects persist into late pregnancy after cessation of treatment. On Day 20 of pregnancy, mothers were anaesthetised and a mini osmotic pump was implanted subcutaneously, to deliver 1mg/kg/day IGF-I (n = 7), IGF-II (n = 9) or vehicle (n = 7) for 17 days. Guinea pigs were killed on Day 62 of pregnancy (term ~67 days). Fetal and placental weights, and maternal and fetal body composition, were measured. Total litter size was unaffected by IGF treatment; however, IGF-II increased the number of viable fetuses by 26% (P = 0.01). After adjusting for the number of viable pups per litter, maternal IGF treatment increased fetal growth by increasing abdominal circumference, crown-rump length and fetal weight (fetal weight: IGF-I 79+/–2.5 g; IGF-II 78+/–2.6 g; vs vehicle 68+/–2.5 g, P = 0.02). IGF treatment did not alter absolute or relative fetal organ weights. IGF-I reduced placental weight by 9% and IGF-II increased it by 9%, but not significantly. IGF-I increased the fetal weight�:�placental weight ratio (19+/–0.9 vs 15+/–0.9, respectively P = 0.043). IGF treatment did not affect maternal weight gain during pregnancy nor net carcass weight; however, IGF-I reduced maternal lung and adipose tissue weights. In conclusion, maternal IGF-II treatment during early pregnancy improved fetal growth into late gestation, possibly by modulating placental efficiency. As poor placental development is implicated in fetal growth restriction, increasing maternal IGF abundance in early to mid pregnancy may be a potential therapeutic approach to placental insufficiency.

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