Predictors of High Grade and Other Clinically Significant Placental Findings by Indication for Submission in Singleton Placentas From Term Births

2020 ◽  
Vol 23 (4) ◽  
pp. 274-284
Author(s):  
Yi Yuan Zhou ◽  
Sanjita Ravishankar ◽  
Guangju Luo ◽  
Raymond W Redline
Keyword(s):  
Gestational Age ◽  
Umbilical Artery ◽  
Maternal Obesity ◽  
Large For Gestational Age ◽  
Chronic Hypertension ◽  
Low Grade ◽  
High Grade ◽  
Single Umbilical Artery ◽  
Clinically Significant ◽  
Term Births

Indications for placental submission are variable. Established guidelines are largely based on expert opinion, and there is a need for more evidence-based criteria. A 10-year database of term placentas was used to evaluate indications significantly associated with placental pathology. Lesions in 5 categories were separated into high- and low-grade subgroups. Two additional high-grade lesions were also evaluated. Indications associated with high-grade placental lesions were chronic monitoring abnormalities, severe preeclampsia, pregestational diabetes, maternal signs of infection, postdates pregnancy, artificial reproductive technology, drug abuse, umbilical cord entanglements, selected gross placental abnormalities, stillbirth, Apgar 5 minutes <6, small-for-gestational age infant, and macrosomia. Indications for which placental findings did not differ from the population as a whole were acute monitoring abnormalities, chronic hypertension, maternal obesity, vaginal bleeding, accessory lobe/multilobed placenta, meconium-stained fluid, single umbilical artery, and borderline large-for-gestational age infant. Other indications for submission were intermediate showing significant or borderline elevations in the prevalence of low- and high-grade lesions combined. We suggest on the basis of this study that guidelines for the submission of singleton term placentas could be modified to exclude cases with clinical indications that lack a significant association with placental lesions.

scholarly journals Plasma IL-1 Receptor Antagonist Concentration Has an Inverse Association With Birth Weight in Prepubertal Children

2018 ◽  
Vol 2 (3) ◽  
pp. 232-239 ◽  
Author(s):  
Henrikki Nordman ◽  
Raimo Voutilainen ◽  
Leena Antikainen ◽  
Jarmo Jääskeläinen
Keyword(s):  
Receptor Antagonist ◽  
Gestational Age ◽  
Standard Deviation Score ◽  
Large For Gestational Age ◽  
Birth Size ◽  
Study Cohort ◽  
Low Grade ◽  
Inverse Association ◽  
Prepubertal Children ◽  
Hs Crp

Abstract Context Birth size has an impact on later cardiometabolic risk that is strongly related to low-grade inflammation. Objective To evaluate plasma interleukin-1 receptor antagonist (IL-1ra) concentrations in relation to birth size and cardiometabolic and inflammatory markers in prepubertal children. Design A cohort study. Anthropometric data were recorded. Fasting blood samples were collected for plasma analyses of IL-1ra, alanine transaminase, total cholesterol, high- and low-density lipoprotein cholesterols, triglyceride, glucose, and serum analyses of 25-hydroxyvitamin D [25(OH)D] and high-sensitivity C-reactive protein (hs-CRP) concentrations. Participants Forty-nine large for gestational age (LGA), 56 appropriate for gestational age, and 23 small for gestational age (SGA) children at 5 to 8 years of age were examined. Main Outcome Measures Differences in IL-1ra concentrations among the birth-size groups and associations between IL-1ra and other metabolic markers were assessed. Results Body mass index (BMI) standard deviation score (SDS)-adjusted plasma IL-1ra concentrations were highest in the SGA- and lowest in the LGA-born children (P = 0.015). Age- and sex-adjusted IL-1ra concentrations had strongest associations with BMI SDS (P &lt; 0.001) and hs-CRP (P &lt; 0.001, also when further adjusted for BMI SDS). Conclusions Prepubertal children born SGA had the highest and those born LGA the lowest IL-1ra concentrations in this study cohort. Most associations found between IL-1ra and the studied metabolic parameters were weight related, but the association with hs-CRP remained strong after adjustment for BMI. It seems that at prepuberty, SGA children have a stronger inflammatory state than LGA children and may thus be at a greater risk for later metabolic disturbances.

scholarly journals Maternal obesity, diabetes mellitus and cord blood biomarkers in large-for-gestational age infants

2016 ◽  
Vol 01 (03) ◽  
pp. 217-224
Author(s):  
Fengxiu Ouyang ◽  
Nana Matoba ◽  
Colleen Pearson ◽  
Katherin Ortiz ◽  
Xiaobin Wang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cord Blood ◽  
Gestational Age ◽  
Maternal Obesity ◽  
Large For Gestational Age ◽  
Blood Biomarkers

scholarly journals Pregnancy Outcomes in Young Women With Youth-Onset Type 2 Diabetes Followed in the TODAY Study

2021 ◽  
Author(s):  
Jeanie B. Tryggestad ◽  
Megan M. Kelsey ◽  
Kimberly L. Drews ◽  
Steven D. Chernausek ◽  
Elia N. Escaname ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Young Women ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Self Report ◽  
Large For Gestational Age ◽  
Chronic Hypertension ◽  
Onset Type ◽  
Contraception Use

<b>Objective:</b> To assess pregnancy outcomes in young women with youth-onset type 2 diabetes followed in the TODAY study. <p><em><b>Research Design and Methods:</b></em><em> </em>Pregnancy information (outcome, any maternal or fetal complications) was obtained from the female participants by self-report. Additionally, medical records for the pregnancy and the child’s neonatal course were obtained with data abstracted into standardized forms.<em></em></p> <p><b>Results:</b> Over a maximum of 15 years, 260 pregnancies were reported by 141 women (age 21.5 years ± 3.2 years, BMI 35.6 ± 7.2 kg/m<sup>2</sup>, diabetes duration 8.1 ± 3.2 years). Contraception use prior to pregnancy reported by 13.5% of the women. Complications were reported by 65% of the women during their pregnancy. Pregnancy loss was observed in 25.3% and preterm birth in 32.6% of pregnancies. HbA1c ≥ 8% was observed in 31.9% of the pregnancies and 35% of the pregnancies were complicated by chronic hypertension. Nephropathy prior to pregnancy was observed in 25% of the women. In the offspring, 7.8% were classified as small for gestational age, 26.8% large for gestational age, and 17.9% in the macrosomic range.</p> <b>Conclusion:</b> Based on observations from the TODAY cohort, young women with pre-gestational, youth-onset type 2 diabetes had very high rates of maternal complications stemming from significant socioeconomic disadvantage. The substantial maternal and infant complications seen in these young moms could potentially be avoided with improved contraception rates and reproductive planning.

scholarly journals Pregnancy Outcomes in Young Women With Youth-Onset Type 2 Diabetes Followed in the TODAY Study

2021 ◽  
Author(s):  
Jeanie B. Tryggestad ◽  
Megan M. Kelsey ◽  
Kimberly L. Drews ◽  
Steven D. Chernausek ◽  
Elia N. Escaname ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Young Women ◽  
Gestational Age ◽  
Pregnancy Outcomes ◽  
Self Report ◽  
Large For Gestational Age ◽  
Chronic Hypertension ◽  
Onset Type ◽  
Contraception Use

<b>Objective:</b> To assess pregnancy outcomes in young women with youth-onset type 2 diabetes followed in the TODAY study. <p><em><b>Research Design and Methods:</b></em><em> </em>Pregnancy information (outcome, any maternal or fetal complications) was obtained from the female participants by self-report. Additionally, medical records for the pregnancy and the child’s neonatal course were obtained with data abstracted into standardized forms.<em></em></p> <p><b>Results:</b> Over a maximum of 15 years, 260 pregnancies were reported by 141 women (age 21.5 years ± 3.2 years, BMI 35.6 ± 7.2 kg/m<sup>2</sup>, diabetes duration 8.1 ± 3.2 years). Contraception use prior to pregnancy reported by 13.5% of the women. Complications were reported by 65% of the women during their pregnancy. Pregnancy loss was observed in 25.3% and preterm birth in 32.6% of pregnancies. HbA1c ≥ 8% was observed in 31.9% of the pregnancies and 35% of the pregnancies were complicated by chronic hypertension. Nephropathy prior to pregnancy was observed in 25% of the women. In the offspring, 7.8% were classified as small for gestational age, 26.8% large for gestational age, and 17.9% in the macrosomic range.</p> <b>Conclusion:</b> Based on observations from the TODAY cohort, young women with pre-gestational, youth-onset type 2 diabetes had very high rates of maternal complications stemming from significant socioeconomic disadvantage. The substantial maternal and infant complications seen in these young moms could potentially be avoided with improved contraception rates and reproductive planning.

scholarly journals Perinatal Outcomes of Small for Gestational Age Neonates Born With an Isolated Single Umbilical Artery

2019 ◽  
Vol 7 ◽  
Author(s):  
Maayan Blum ◽  
Adi Y. Weintraub ◽  
Yael Baumfeld ◽  
Reut Rotem ◽  
Gali Pariente
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Umbilical Artery ◽  
Perinatal Outcomes ◽  
Single Umbilical Artery

353: The influence of maternal obesity on the sonographic evaluation of large for gestational age (LGA) infants?

2011 ◽  
Vol 204 (1) ◽  
pp. S144
Author(s):  
Katherine Goetzinger ◽  
Methodius Tuuli ◽  
Anthony Odibo ◽  
Kimberly A. Roehl ◽  
George Macones ◽  
...  
Keyword(s):  
Gestational Age ◽  
Maternal Obesity ◽  
Large For Gestational Age ◽  
Sonographic Evaluation

Individualized sex-specific birth weight percentiles for gestational age based on maternal height and weight

2021 ◽  
Vol 49 (1) ◽  
pp. 94-103
Author(s):  
Manfred Voigt ◽  
Niels Rochow ◽  
Erin Landau-Crangle ◽  
Lena Marie Meyer-Kahrweg ◽  
Dirk M. Olbertz ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Large For Gestational Age ◽  
The Novel ◽  
Maternal Height ◽  
Complete Dataset ◽  
Significant Difference ◽  
Clinically Significant ◽  
The Impact ◽  
Weight Groups

AbstractObjectivesThe maternal body size affects birth weight. The impact on birth weight percentiles is unknown. The objective of the study was to develop birth weight percentiles based on maternal height and weight.MethodsThis observational study analyzed 2.2 million singletons from the German Perinatal Survey. Data were stratified into 18 maternal height and weight groups. Sex-specific birth weight percentiles were calculated from 31 to 42 weeks and compared to percentiles from the complete dataset using the GAMLSS package for R statistics.ResultsBirth weight percentiles not considering maternal size showed 22% incidence of small for gestational age (SGA) and 2% incidence of large for gestational age (LGA) for the subgroup of newborns from petite mothers, compared to a 4% SGA and 26% LGA newborns from big mothers. The novel percentiles based on 18 groups stratified by maternal height and weight for both sexes showed significant differences between identical original percentiles. The differences were up to almost 800 g between identical percentiles for petite and big mothers. The 97th and 50th percentile from the group of petite mothers almost overlap with the 50th and 3rd percentile from the group of big mothers.ConclusionsThere is a clinically significant difference in birth weight percentiles when stratified by maternal height and weight. It could be hypothesized that birth weight charts stratified by maternal anthropometry could provide higher specificity and more individual prediction of perinatal risks. The new percentiles may be used to evaluate estimated fetal as well as birth weight.

Pentalogy of cantrell with single umbilical artery: a rare fetal anomaly

2016 ◽  
Vol 4 (1) ◽  
pp. 280 ◽  
Author(s):  
Raj Kumar Meena ◽  
Veena Meena
Keyword(s):  
Abdominal Wall ◽  
Gestational Age ◽  
Umbilical Artery ◽  
Abdominal Wall Defect ◽  
Fetal Anomaly ◽  
Single Umbilical Artery ◽  
Fetal Autopsy ◽  
Dorsal Midline ◽  
Pentalogy Of Cantrell ◽  
Midline Defects

Pentalogy of cantrell (PC) is a rare syndrome having both specific ventral and dorsal midline defect, and rarely found to be associated with other anomalies. Most cases occur randomly for no apparent reason (sporadically). We report a 20 years old primigravida referred at 17 weeks 4 days of gestational age, for a fetal anomaly scan having an anterior abdominal wall defect in fetus. Ultrasound done, showed single live fetus gestational age of 18 weeks, with fetal heart, great vessels, stomach, and intestinal loops were found to be lying outside thoracic cavity. Fetal autopsy following termination of the pregnancy confirmed the presence of the malformations with single umbilical artery. Occurrence of both ventral and dorsal midline defects suggests that the timing of fetus insult would be between 14 to 18 days after conception when the splanchnic mesoderm (myocardium) and somatic mesoderm (sternum, abdominal wall, diaphragm and pericardium) is dividing.

Sign in / Sign up

Export Citation Format

Share Document