A clinicopathologic study of placentae of low birth weight and normal birth weight babies born at a tertiary care center in western India

Abstract

Context: Low birth weight (LBW) of newborn is associated with various clinical parameters as well as with placental pathology. Aims: This study aims to assess and compare the clinical parameters and placental pathology in LBW infants with normal infants. Subjects and Methods: Thirty-four placentae of full-term babies weighing <2.5 kg were taken as cases and 34 placentae of newborns weighing more than 2.5 kg were taken as controls. Clinical data parity, maternal age, weight, height, body mass index (BMI), mode of delivery, and period of gestation were collected. Gross examination, placental parameters: attachment of cord, placental dimensions, placental weight, infarction, and hematoma were noted. Sections were studied for accelerated villous maturation (syncytial knots), developmental villous capillary lesion (chorangiosis), acute infectious inflammatory lesions (chorioamnionitis), chronic infectious inflammatory lesions (stromal fibrosis), and other placental processes (massive perivillous fibrin deposition [ MPVFD], fibrinoid necrosis, atherosis, and calcification). Statistical Analysis: Chi-square test and logistic regression were performed on dichotomous variables with SPSS 20 to find association. Quantitative variables were analyzed by Unpaired T-test and Mann–Whitney's test for significance. P < 0.05 was taken as statistically significant. Results: The mean maternal age (26.7 years) was higher (P = 0.039) than controls (24.8 years); mean maternal weight (P = 0.14)], BMI (P = 0.029), and period of gestation (P = 0.0) were lower in cases than in controls. Cases and controls showed significant difference in eccentric attachment of umbilical cord (61.76% vs. 32.35%, [P = 0.015*]). On microscopy cases showed significant MPFD (P = 0.015*). A significantly higher stromal fibrosis (P = 0.028), atherosis (P = 0.024), ST knots (P = 0.012), and chorangiosis (58.82% vs. 26.47% [P = 0.007]) were noted in cases. Conclusions: We conclude that all placentas should be examined thoroughly to look for associated characteristic histomorphologic and gross findings which reflect hypoxia and decreased maternal fetal nutrient transfer.