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The effect of pregnancy‐induced hypertensive disorders on placental growth along short and long axes and neonatal outcomes
Author(s) -
Phad Neelkanth,
Dahlstrom Jane E.,
Ellwood David,
Kent Alison L.
Publication year - 2015
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/ajo.12308
Subject(s) - medicine , pregnancy , obstetrics , placenta , gestational hypertension , birth weight , fetus , retrospective cohort study , gestational age , small for gestational age , gestation , eclampsia , preeclampsia , cohort , hypertensive disorder , genetics , biology
Aim To assess the effect of pregnancy‐induced hypertensive disorders on the growth of the placenta on the short and long axes and neonatal outcomes. Materials and Methods A retrospective cohort study of gross and histological characteristics of placentas and the fetal outcomes of normotensive and hypertensive pregnancies over a three‐year period from January 2009 to December 2011 at a tertiary teaching hospital in ACT , Australia. Results Placentas and neonatal outcomes from 100 pregnancies complicated with pregnancy‐induced hypertension/pre‐eclampsia were studied and compared with 51 gestational age‐matched placentas and neonatal outcomes from normotensive pregnancies. The median maternal age and smoking history were similar in the two groups ( P = 0.894; P = 1.00, respectively). The median pre‐pregnancy weight was significantly higher ( P < 0.001) and primiparity more common ( P = 0.001) in the study group. The median weight of the placenta was significantly lower ( P < 0.001) and below the 10th centile ( P < 0.001) in the study group. Both the long and short axes of the placental disc were significantly smaller in the study group ( P = 0.002; P ≤ 0.001 respectively). Accelerated villous maturation, placental infarcts and decidual vessel vasculopathy were more common in the study group ( P < 0.001). The median birthweight and the number of infants with birthweight and length below the 10th centile were significantly higher in the study group ( P = 0.008; P < 0.001; P = 0.004, respectively). Conclusion This study demonstrates that pregnancy‐induced hypertension significantly influences the growth and development of both the placenta and fetus.