Placental sites and preeclampsia in singleton pregnancy: a retrospective cohort study
Abstract
OBJECTIVE
To ascertain the association between placental sites and the development of preeclampsia
METHODS
We conducted a retrospective cohort study of 1,080 singleton pregnant women with spontaneous delivery from May 2014 to January 2016 at Khon Kaen Hospital, Thailand comparing development of preeclampsia between lateral placental site and central placental site. Their medical records were reviewed for placental sites and other variables. The primary outcome was developing preeclampsia. The secondary outcomes were placental abruption, postpartum hemorrhage, preterm labor, intrauterine fetal death, low birth weight, macrosomia, APGAR score, birth weight and placental weight.
RESULTS
A total of 1,080 records of singleton pregnant women were reviewed (257 in the lateral placental site group and 823 in the central placental site group). There was no significant difference between the two groups in the rate of developing preeclampsia; 24 pregnant women (9.3%) in former group and 60 pregnant women (7.3%) in later group (adjusted odds ratio [AOR], 0.67 95% confidence interval [CI], 0.39 to 1.16; P=0.151). Furthermore, there were not different regarding placental abruption, postpartum hemorrhage, preterm labor, intrauterine fetal death, low birth weight, macrosomia, APGAR score, birth weight and placental weight.
CONCLUSIONS
In singleton pregnant women with spontaneous delivery, we found no association between placental sites and developing preeclampsia.
References
Abalos E, Cuesta C, Grosso AL, Chou D, Say L. Global and regional estimates of preeclampsia and eclampsia: a systematic review. European Journal of Obstetrics and Gynecology and Reproductive Biology. 2013 Sep 1;170(1):1–7.
Khan, Khalid S et al. "WHO analysis of causes of maternal death: a systematic review." The lancet 367.9516 (2006): 1066-1074.
Contro E, Maroni E, Cera E, Youssef A, Bellussi F, Pilu G, et al. Unilaterally increased uterine artery resistance, placental location and pregnancy outcome. Eur J Obstet Gynecol Reprod Biol. 2010 Dec;153(2):143–7.
Fisher SJ. Why is placentation abnormal in preeclampsia? Am J Obstet Gynecol. 2015 Oct;213(4 Suppl):S115-122.
Maynard SE, Karumanchi SA. Angiogenic Factors and Preeclampsia. Semin Nephrol. 2011 Jan;31(1):33–46.
Zia S. Placental location and pregnancy outcome. J Turk Ger Gynecol Assoc. 2013 Dec 1;14(4):190–3.
Steegers EAP, von Dadelszen P, Duvekot JJ, Pijnenborg R. Pre-eclampsia. Lancet. 2010 Aug 21;376(9741):631–44.
Yousuf S, Ahmad A, Qadir S, Gul S, Tali SH, Shaheen F, et al. Utility of Placental Laterality and Uterine Artery Doppler Abnormalities for Prediction of Preeclampsia. J Obstet Gynecol India. 2016 Feb 26;1–5.
Kofinas AD, Penry M, Greiss FC, Meis PJ, Nelson LH. The effect of placental location on uterine artery flow velocity waveforms. American Journal of Obstetrics and Gynecology. 1988 Dec;159(6):1504–8.
Ito, Yuji et al. "Resistance index of uterine artery and placental location in intrauterine growth retardation." Acta obstetricia et gynecologica Scandinavica 77.4 (1998): 385-390.
Meler E, Figueras F, Bennasar M, Gomez O, Crispi F, Gratacos E. The prognostic role of uterine artery Doppler investigation in patients with severe early-onset preeclampsia. Am J Obstet Gynecol. 2010 Jun;202(6):559.e1-4.
Rampello S, Frigerio L, Ricci E, Rota E, Lucianetti M, Parazzini F. Transabdominal uterine arteries Doppler at 12–14th and 20–24th week of gestation and pregnancy outcome: A prospective study. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2009 Dec;147(2):135–8.
Oloyede OA, Iketubosin F. Uterine artery Doppler study in second trimester of pregnancy. Pan Afr Med J [Internet]. 2013 Jul 5 [cited 2016 Sep 5];15. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3810287/
Giordano R, Cacciatore A, Romano M, La Rosa B, Fonti I, Vigna R. Uterine artery Doppler flow studies in obstetric practice. J Prenat Med. 2010;4(4):59–62.
Kakkar T, Singh V, Razdan R, Digra SK, Gupta A, Kakkar M. Placental Laterality as a Predictor for Development of Preeclampsia. J Obstet Gynaecol India. 2013 Mar;63(1):22–5.
Seckin KD, Cakmak B, Karsli MF, Yeral MI, Gultekin IB, Oz M, et al. Is lateral localisation of placenta a risk factor for adverse perinatal outcomes? J Obstet Gynaecol. 2015;35(7):696–8.
Devarajan K, Kives S, Ray JG. Placental location and newborn weight. J Obstet Gynaecol Can. 2012 Apr;34(4):325–9.
Ota, Erika et al. "Risk factors of pre-eclampsia/eclampsia and its adverse outcomes in low-and middle-income countries: a WHO secondary analysis." PloS one 9.3 (2014): e91198.
English, Fred A, Louise C Kenny, and Fergus P McCarthy. "Risk factors and effective management of preeclampsia." Integrated blood pressure control 8 (2015): 7.
Direkvand-Moghadam, Ashraf, Afra Khosravi, and Kourosh Sayehmiri. "Predictive factors for preeclampsia in pregnant women: a Receiver Operation Character approach." Arch Med Sci 9.4 (2013): 684-9.
Bartsch, Emily et al. "Clinical risk factors for pre-eclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies." bmj 353 (2016): i1753.
Kiondo, Paul et al. "Risk factors for pre‐eclampsia in Mulago Hospital, Kampala, Uganda." Tropical Medicine & International Health 17.4 (2012): 480-487.
Aksornphusitaphong, Adisorn, and Vorapong Phupong. "Risk factors of early and late onset pre‐eclampsia." Journal of Obstetrics and Gynaecology Research 39.3 (2013): 627-631.
Levine, Richard J et al. "Circulating angiogenic factors and the risk of preeclampsia." New England Journal of Medicine 350.7 (2004): 672-683.
Agrawal, Sutapa, and Gagandeep K Walia. "Prevalence and risk factors for Pre-eclampsia in Indian women: a national cross sectional study." South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi (2010).
Kiondo, Paul et al. "Adverse neonatal outcomes in women with pre-eclampsia in Mulago Hospital, Kampala, Uganda: a cross-sectional study." The Pan African medical journal 17.Suppl 1 (2014).
