Difference In Placental Weight Research Articles

Inflammatory Bowel Disease and Associated Placental Histopathology [ID 2683599

INTRODUCTION: Inflammatory bowel disease (IBD) has been associated with adverse obstetric outcomes, but its effect on placental histopathology is not well studied. We sought to determine the placental histopathology findings associated with maternal IBD. METHODS: This is an IRB-approved retrospective cohort study of patients with IBD who delivered singleton live births at a single institution from October 2019 to April 2023 and had placental pathology available. Participants were identified using an ultrasound query for “Crohn’s” or “ulcerative colitis” (UC). Cases with fetal aneuploidy or major anomalies were excluded. Controls were matched 2:1 for maternal age, gestational age at delivery, and medical comorbidities. Demographics, pregnancy outcomes, and pathology findings were obtained from the electronic medical record. Mann–Whitney and Fisher's exact tests were used with significance set at P<.05. RESULTS: Placental pathology was compared between 18 IBD participants (11 Crohn's, seven UC) and 36 controls. Of 18 IBD participants, three were treated with sulfasalazine, seven with TNF-α inhibitors, and eight used no medication. Baseline demographics and cesarean delivery rates were similar between groups. Five participants per group had histologic evidence of acute chorioamnionitis and/or funisitis (27.8% versus 13.9%; P=.27). Three IBD participants demonstrated maternal vascular malperfusion (MVM) versus 15 controls (16.7% versus 41.7%; P=.07). There were no differences in placental weight, meconium, or fetal vascular malperfusion. CONCLUSION: Inflammatory bowel disease was not associated with adverse placental histopathology. Decreased incidence of MVM may result from IBD medications reducing systemic inflammation. Larger studies are warranted to further evaluate the effect of IBD on placental pathology.

Factors Influencing Adverse Pregnancy Outcomes in Gestational Diabetes Mellitus.

Objective Analysis of gestational diabetes risk factors and their impact on pregnancy outcomes. Methods A retrospective analysis of pregnant women who delivered in the obstetrics ward of a tertiary hospital was performed, and the pregnant women were divided into a case group and a control group according to their compliance with the diagnostic criteria of GDM. The underlying pregnancy, delivery, and pregnancy outcomes of both groups were statistically analyzed. Results The detection rate and incidence rate of gestational diabetes were 13.0%, and the incidence rate was 14.5% compared to pregnancy and childbirth complications between the two groups. No statistical differences in placental weight and cord length were found compared to the sex of the newborns by comparing the basic profile of the two groups of perinatal infants. There was no statistical difference between fetal growth restriction and neonatal abnormalities, while there was a statistical difference in neonatal outcomes between the two groups. Conclusion Age, family history, and weight are the risk factors for GDM.

Are there sex differences in fetal growth strategies and in the long-term effects of pregnancy complications on cognitive functioning?

Males and females have been proposed to have different prenatal growth strategies, whereby males invest more in fetal growth and less in placental development, leaving them more susceptible to early-life adversity. We tested predictions of this hypothesis using data from the National Collaborative Perinatal Project. Male newborns were heavier than females, but there was no difference in placental weight, adjusting for birthweight. Among infants born prior to 33 weeks, the difference in birthweight between males and females was greater among those who did not survive than among those who did, potentially reflecting a strategy whereby males maintained growth in the face of prenatal insults, while females adjusted growth. However, there was no significant difference in mortality between the sexes. Being born small-for-gestational age or very preterm (prior to 33 weeks) was associated with significantly reduced performance for most of the cognitive traits examined at 7 years, although maternal preeclampsia was associated with reduced performance in fewer traits. Generally, these effects of early-life adversity (poor fetal growth, prematurity, and preeclampsia) did not differ between the sexes. However, analyzing the sexes separately (rather than testing the interaction between sex and adversity) resulted in numerous spurious sex-specific effects, whereby the effect of early-life adversity appeared to be significant in one sex but not the other. Overall, we found little support for the hypothesis that males prioritize growth more than females, and that this makes them more susceptible to early-life adversity. Furthermore, our results show that analyzing the sexes separately, rather than testing the adversity by sex interaction, can be highly misleading.

Effect of Thrombopoietin Receptor Agonist on Pregnant Mice.

Thrombopoietin receptor agonists (TPO-RAs) are an effective treatment for refractory immune thrombocytopenia (ITP). However, the use of TPO-RAs is limited for ITP in pregnant women due to concerns about fetal toxicity. In this study, we examined the effects of romiplostim, one of the TPO-RAs, on pregnant mice. The mice were injected subcutaneously with romiplostim (1, 5, 10, 30, and 100 μg/kg) on gestational days (GD) 1, 8, and 15. We evaluated maternal and fetal platelet and megakaryocyte counts (MK), fetal weight at birth, placental morphology, and miscarriage rates. Romiplostim increased platelet and MK counts in pregnant mice at all doses and in fetuses at doses above 10 µg/kg. Fetal weight at birth was slightly reduced at a dose of 100 μg/kg, but there were no significant differences in placental weight, spiral artery wall thickness, placental growth factor signal changes, or the rate of resorption at that dosage. The dose of romiplostim used clinically for ITP patients (1–10 μg/kg) did not show any adverse effects on pregnant mice. Although the results of the present study are encouraging, until there are more conclusive data, the use of romiplostim should be evaluated individually in severe, life-threatening cases, and all relevant ethical aspects should be considered.

The effects of exercise during pregnancy on placental composition: A systematic review and meta-analysis.

Morphological changes to the placenta occur as the demands of the foetus increase throughout gestation. Physical activity during pregnancy is known to benefit both the mother and infant, however the impact of antenatal exercise training on placental development is less known. The aim of this systematic review and meta-analysis was to investigate the effects of exercise training during pregnancy on measures of placental composition. Six electronic databases were searched from inception to June 2021 for studies comparing regular antenatal exercise with either usual maternal care or no exercise for its effect on measures of placental morphological composition. Meta-analyses were performed for placental weight and the placental weight to birthweight (PWBW) ratio. Seven randomised controlled trials and two cohort studies were included in the systematic review and meta-analysis (n=9). There was no significant difference in placental weight (mean difference (MD)=-9.07g, p=0.42) or the PWBW ratio (MD=0.00, p=0.32) between exercise and control groups. Parenchymal tissue volume was higher, represented by an increase in villous tissue, and non-parenchymal volume was lower in women who exercised regularly compared to those that were not exercising during pregnancy. Exercise training during pregnancy may not alter placental weight or the PWBW ratio. However, findings from this review indicate that antenatal exercise training can promote advantageous morphological changes to placental tissues.

Association of placental pathology and gross morphology with autism spectrum disorders.

This study evaluated the association between placental pathology and gross morphology and the risk of autism spectrum disorders (ASD). We conducted a matched case-control study of children with confirmed ASD who were born between 2000 and 2017 at one of three university-affiliated hospitals in Montreal, Quebec. Cases, who were identified through the Montreal Children's Hospital Autism Spectrum Disorders Program, were matched to babies (1:5) born at the same hospital and on the same day. Multi-fetal births were excluded. Maternal demographics, pregnancy characteristics and placental pathologies were collected from hospital charts by abstractors blind to autism diagnoses. This current study consisted of data from a single-site that had pathology reports available. Pearson chi-square and Wilcoxon rank-sum tests were used to estimate p-values. Our study consisted of 107 ASD cases and 526 matched controls. Mothers of cases and controls were similar in terms of parity, gravidity, smoking status, BMI, rates of clinical chorioamnionitis, chronic hypertension, and gestational diabetes. Age at delivery of <25 years was more common among mothers of controls. Compared with controls, cases were more likely born male, <32 weeks of gestation, and weighing <1500 g. Cases and controls had similar rates of placental inflammation, vasculitis, and other placental pathologies. There were no differences in placental weight, placental thickness, umbilical cord length, and umbilical cord insertion between the two groups. In conclusion, placental pathology and gross morphology do not appear to be associated with ASD, suggesting that any perinatal determinants of autism are not likely to be mediated through placental pathology. LAY SUMMARY: Data from a matched case-control study consisting of neonates born between 2000 and 2017 at one of three McGill-affiliated hospitals were used to examine the relationship between placental pathology and morphology and the development of autism. No differences in placental pathology and gross morphology were found between those with and without autism, which suggests that placental abnormalities are unlikely to either cause or mediate the development of autism.

Maternal Anti-αIIb Antibodies Target Fetal Hematopoietic Stem Cells and May Lead to Pancytopenia and Miscarriage in Fnait

Background: Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a devastating disorder characterized by an aberrant maternal immune response against paternally inherited polymorphisms on fetal platelet antigens. Affected fetuses can experience severe bleeding (e.g. intracranial hemorrhage; ICH), neurological sequelae and death. The targeted platelet antigens are located predominantly on platelet surface receptor αIIbβ3 integrin. It is estimated that 0.5-1.5/1000 live neonates are born with FNAIT although this incidence may largely underestimate the prevalence of the disease due to miscarriage. We have previously demonstrated that anti-β3 alloantibodies can target not only fetal platelets but also the β3 subunit on endothelial cells leading to ICH and placental vascular pathologies (J Clin Invest. 2015; Nat Commun. 2017). Although the number of polymorphisms in the αIIb subunit is similar to the β3 subunit, reported incidences of anti-β3 mediated FNAIT are far greater. It is currently unknown whether this due to miscarriage in anti-αIIb mediated FNAIT. αIIb was previously considered to be exclusively expressed on platelets, however hematopoietic stem cells (HSCs) and their early progenitors can express αIIbβ3 during embryonic development and αIIb is one of the earliest markers of hematopoietic commitment. Throughout gestation, HSCs migrate from yolk sac to the aorta-gonadal-mesonephros, placenta, fetal liver and finally bone marrow. We hypothesize that miscarriage is prevalent in anti-αIIb mediated FNAIT and that maternal anti-αIIb antibodies may target HSCs resulting in decreased blood cell counts, increased bleeding and fetal death.Methods: We established an animal model of anti-αIIb mediated FNAIT by immunizing αIIb-/- mice with 108 wild-type (WT, αIIb+/+) platelets. Immunized αIIb-/- mice were then bred with WT males. We used non-immunized (naïve) αIIb-/- x WT breeding pairs as a control. Sera of immunized and naïve mice were collected prior to breeding and ultrasound was used to detect fetal death. Mice were sacrificed at E14.5 and fetuses, placentas and fetal livers were weighed. Cell suspensions were prepared from these tissues as well as fetal blood and analyzed with flow cytometry. Fluorescent markers were used to identify HSCs (CD34+/CD117+/Lin- or CD34+/CD45+) and blood cell counts for T cells (CD3+,CD4+,CD8+), B cells (CD19+), myeloid lineage cells (CD11b+) and megakaryocytes (GPIbα+).Results: Sera of immunized mice showed a significant anti-αIIb immune response. Pups of immunized mice had low platelet counts, reduced body weight and bleeding diathesis. Ultrasound revealed miscarriage occurred mainly at E14.5 of immunized αIIb+/- fetuses. The miscarriage rate in our anti-αIIb mediated FNAIT model appeared significantly higher than the anti-β3 model. At E14.5, our results showed live fetuses of immunized mice had significantly lower body and liver weight although no significant difference in placental weight was observed. We found fetal liver HSCs have increased maternal antibody binding when incubated with sera from immunized αIIb-/- mice versus naïve αIIb-/- mice in vitro, suggesting that maternal anti-αIIb antibodies target fetal HSCs in vivo . Preliminary data also demonstrated that fetuses in the immunized group had reduced overall HSCs as well as αIIb+ HSC subsets in the placenta, liver and yolk sac. Fetal blood analysis showed reduced hematopoietic lineage cells in the immunized group, particularly T cells (CD3+), B cells and megakaryocytes.Conclusions: We established an anti-αIIb mouse model of FNAIT and revealed a high rate of miscarriage, which may explain the paucity of reported human cases. Our results indicate maternal anti-αIIbantibodies may bind and target fetal HSCs during embryonic development, which contributes significantly to impaired placental and fetal liver development, and fetal death. Destruction of early αIIb+ HSC progenitors may explain the decrease in HSCs (both αIIb+ and αIIb-) and account for the pancytopenia in FNAIT fetuses. Further experiments are in progress to elucidate the mechanism by which destruction of αIIb+ HSCs contributes to fetal pathology.*J.S. and B.E.O contributed equally to this work DisclosuresNo relevant conflicts of interest to declare.

Placental weight in first generation migrant mothers in Germany. Do the length of stay, acculturation or migrant status play a role?

IntroductionMigration status affects perinatal outcomes. A small placenta is associated with placental dysfunction and poor outcomes. Placental weight and perinatal outcomes are influenced by migrant status, the length of stay and the level of acculturation in the host country.Our aim was to compare placental weight in first generation immigrants to native non-immigrants in a teaching hospital in Berlin. The influence of migrant status, the length of stay and the level of acculturation on placental weight was also ascertained. MethodsAt the Charité University Hospital in Berlin Germany between January 2011 and January 2012, 1373 non-migrant and 1243 first generation migrants were included. Data collection was by means of a standardized questionnaire. The level of acculturation was based on the Frankfurter Acculturation Questionnaire (Frankfurter Akkulturationsfragebogen-FRAKK). Demographic parameters such as age, maternal weight, country of origin, parity, anemia, diabetes, hypertension, smoking and neonatal outcomes including neonatal weight, placental weight were measured. ResultsWe found no difference in mean placenta weight when comparing first generation women with a migration background to women of the native population (608 g vs 597 g, p-value 0.41). There was also no difference in placental weight when assessed by the length of stay and degree of acculturation in the host country. DiscussionWhile first generation migrant women have increased perinatal complications, there is no influence of migrant status, length of stay and the degree of acculturation on placenta weight. Pregnancy outcomes maybe be more dependent on factors such as the access to adequate maternal care.

496 Association of placental pathology and autism spectrum disorders

Emerging findings suggest that perinatal factors may influence the risk of developing autism spectrum disorders (ASD). Abnormal placentation has been proposed as a potential risk factor. We aimed to evaluate the association between placental pathology and gross morphology with ASD. We conducted a matched case-control study of children with confirmed autism who were born between 2000 and 2017 at one of three university-affiliated hospitals in Montreal, Quebec. Cases, who were identified through the Montreal Children’s Hospital Autism Spectrum Disorders Program, were matched to babies (1:5) born on the same day and hospital. Multi-fetal births were excluded. Data on pregnancy characteristics and placental pathologies were collected from maternal and infant hospital charts by abstractors blind to autism diagnoses. This study is the analysis of data from a single-site that had pathology reports available. Pearson chi-squared and Wilcoxon rank-sum tests were used to estimate p-values. During the study period, 107 babies born at this Montreal area hospital were later diagnosed with ASD. Mothers of cases and controls were similar in parity, gravidity, and BMI, with no differences in frequency of chronic hypertension, gestational diabetes, and clinical chorioamnionitis. Mothers of cases were slightly older in age and were more frequently smokers. Cases were more likely male (78% vs 52%), born slightly earlier, and were heavier in weight. There were no differences in placental abnormalities between cases and controls, with 18% of each group possessing at least one placental abnormality, including chorioamnionitis, vasculitis, decidual inflammation, chorionitis, funisitis, and villitis. Placental hypermaturity was more common among cases (p=0.002). No differences in placental weight, thickness, umbilical cord length, and umbilical cord insertion were found between cases and controls. This study suggests that placentation, placental infections, or placental abnormalities do not increase the risk of development of ASD.

L-arginine supplementation during the final third of gestation improves litter uniformity and physical characteristics of neonatal piglet thermoregulation.

The study assessed the effects of dietary L-arginine supplementation from days 85 to 115 of gestation on sow performance, litter quality, piglet physiology and survival variables in the first 24hr of life. Twenty multiparous sows, with a history of hyperprolificacy (more than 14 piglets per litter), were used. A completely randomized experimental design was used, consisting of two treatments: feed supplemented or not with 1% L-arginine from days 85 to 115 of gestation. The experimental unit consisted of the sow and its respective litter, using 10 replicates per treatment. The sows were distributed into the treatments based on body condition and parity. Supplementation with L-arginine reduced the within-litter standard deviation and the within-litter coefficient of variation of piglet weight at 24hr by 54g and 4.14 percentage points respectively (p=.029; p=.035). Supplementation with 1.0% L-arginine decreased the percentages of piglets weighing less than 800g by 5.60 and 5.08 points at birth and at 24hr of life respectively. Piglets from sows supplemented with L-arginine had higher (p=.088) average rectal temperatures at birth and lower (p=.030) rectal temperature at 24hr of life in comparison with control piglets. No significant differences in placental weight or estimated colostrum production and intake were observed in the first 24hr of life. At 24hr of life, piglets weighing less than 1,000g and from supplemented sows had lower (p=.048) surface/mass ratios and higher body mass index (p=.070). Piglets from supplemented sows and who weighed 1601 to 1,800g had lower body mass index and ponderal index (p=.002; p=.003). Supplementation with L-arginine during the final third of gestation reduces the incidence of unviable piglets (<800g) and improved litter uniformity and piglets' body conformation within the first 24hr of life.

Study of Combination of Nanoherbal Andaliman (Zanthoxylum acanthopodium) and Extra Virgin Olive Oil (EVOO) Effects in the Expression of Malondialdehyde (MDA), Heat Shock Protein-70 (HSP70) and Placental Histology of Preeclamptic Rats

Background: Pre-eclampsia (PE) contributes to the second cause of maternal death in Indonesia. Andaliman is a typical spice of the Batak ethnic in Northern Sumatera Province, Indonesia. This study aimed to explore the potential of novel herbal medicine compound of nanoherbal andaliman and extra virgin olive oil (EVOO) as PE treatment. Methods: Nanoherbal andaliman was generated using High-energy Milling (HEM). The treatments were divided into the following five groups: K- (control): pregnant rats; K+: PE model rats; P1: PE model rats + 0.45 g of EVOO/200 g BW on the 13th–19th day of pregnancy; P2: PE model rats + nanoherbal andaliman 100 mg/200 g BW on the 13th– 19th day of pregnancy; and P3: PE model rats + combination of 0.45 EVOO/200 g BW and nanoherbal andaliman 100 mg/200 g BW on the 13th–19th day of pregnancy. Rats were dissected on the 20th day of pregnancy. The observed parameters were blood pressure, proteinuria, malondialdehyde (MDA), Heat Shock Protein-70 HSP-70 and histology of placenta. Results: A significant difference was noticed (p&lt;0.05) in blood pressure, proteinuria, foetal weight, haematocrit, erythrocytes and trophoblastic cells after the administration of combined nanoherbal andaliman and EVOO. No significant differences in placental weight, foetal number, leukocytes, MDA and HSP-70 were found (p&gt;0.05). Conclusion: The combination of nanoherbal andaliman and EVOO decreased systolic blood pressure and induced the expression of MDA and HSP-70, as well as placental histology of pre-eclamptic rats.

EP18.02: The comparison of placental pathology between small‐for‐gestational‐age (SGA) and appropriate‐for‐gestational‐age (AGA) infants

The present study aimed to evaluate placental morphology in SGA and AGA neonates with using of the macroscopic and microscopic finding of the placenta, membranes and cord. This analytic case-control study was performed from 2016 to 2017 years, between obstetrics and gynecology and pathology departments of Ahvaz Imam Khomeini Hospital. 30 placentas of SGA infants and 30 placenta of AGA infants were examined for pathologies. The obtained placentas were macroscopically examined after removal of extra vessels and isolation of membrane. The histological microscopic examination was taken by an expert pathologist who didn't know the classification of the placentas. Data analysis was performed using SPSS ver.23 (SPSS Inc. Chicago, IL, USA). In this study, 60 women and their neonates were included. The mean age of pregnancy was (37.3 ± 1.5 weeks) 260.9 ± 10.2 days for SGA group and (38.4 ± 0.7 weeks) 269.0 ± 4.8 days for AGA groupsand both groups were matched. Membranes insertion frequency in both groups was reported marginally (the normal insertion at the margin of placenta). There was significant difference in placental weight (p = 0.001) and the fetal placental weight ratio (FPR)(p < 0.001) in SGA and AGA groups. In addition, in Microscopic Examination of the placenta, villousinfarction, decidual necrosis, villitis, chorioangiosis and perivillous fibrin deposition variables were found to be higher in SGA group than AGA group. This study showed that the characteristics of placental insufficiency such as infarct, decidual necrosis, lower placental size, fetal placental weight ratio (FPR), and perivillous fibrin deposition are more common in SGA term neonates than in AGA term neonates. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

367 Organic versus conventional grain on placental factors in caprine

Abstract Organic products are increasing in popularity due to consumer interest and animal products are no exception. Trends towards organic livestock diets have increased yet many questions exist regarding potential health benefits or negative increased cost from the organic product. Organic livestock diets could impact reproductive health yet research into organic feedstuffs is lacking. Previous research examined impacts of diet on placental factors and indicated nutrient transfer from dams to fetus. Impacts of organic practices on livestock reproduction has not been explored, as studies linking nutrition and reproductive abilities have been limited to conventional diets, despite increases in organic practices. The objective of the current study observed differences in placental factors between Nubian dams fed organic and conventional diets. Placental factors were defined as placental weight and cotyledon factors. Six (n = 3) pregnant Nubian dams were separated into an organic group and conventional group based on BW and BCS. The organic group was fed a certified organic concentrate and organic supplement, which had equivalent nutrients to conventional concentrate and supplement. Dams were fed 0.907kg/d/45.4kg of BW of concentrate and 0.012kg/d/45.4kg of BW in individual feeding stocks at 0630 and 1730 for the last six wks of gestation and three wks post-parturition. Upon expulsion of the placenta, the placenta was weighed, cotyledons were counted, and three cotyledons were measured for height, length, width, and volume. Differences in placental weight and cotyledon factors were analyzed by a two-tailed independent T-Test at P &lt; 0.05. No differences were observed for any of the placental aspects (P = 0.486, 0.987, 0.997, 0.468, 0.448, and 0.809, respectively). Placental aspects, such as number and height, may have been influenced by the number of offspring each dam produced, but was not consistent between groups. Based upon the current study, increased cost of organic livestock production may not be justifiable for most goat producers.

More Maternal Vascular Malperfusion and Chorioamnionitis in Placentas After Expectant Management vs. Immediate Delivery in Fetal Growth Restriction at (Near) Term: A Further Analysis of the DIGITAT Trial.

Objective: Management of late fetal growth restriction (FGR) is limited to adequate fetal monitoring and optimal timing of delivery. The Disproportionate Intrauterine Growth Intervention Trial At Term (DIGITAT) trial compared induction of labor with expectant management in pregnancies at (near) term complicated by suspected FGR. Findings of the DIGITAT trial were that expectant monitoring prolonged pregnancy for 10 days and increased birth weight with only 130 grams. This resulted in more infants born below the 2.3rd percentile compared to induction of labor, respectively, 12.5% in induction of labor and 30.6% in expectant monitoring group. The main placental lesions associated with FGR are maternal vascular malperfusion, fetal vascular malperfusion, and villitis of unknown etiology. We investigated whether placentas of pregnancies complicated with FGR in the expectant monitoring group reveal more and more severe pathology due to pregnancy prolongation.Material and methods: The DIGITAT trial was a multicenter, randomized controlled trial with suspected FGR beyond 36 + 0 weeks. We now analyzed all available cases (n = 191) for placental pathology. The macroscopic details were collected and histological slides were recorded and classified by a single perinatal pathologist, blinded for pregnancy details and outcome. The different placental lesions were scored based on the latest international criteria for placental lesions as defined in the Amsterdam Placental Workshop Group Consensus Statement.Results: The presence of maternal vascular malperfusion and chorioamnionitis were higher in the expectant management group (p < 0.05 and p < 0.01, respectively). No differences in placental weight and maturation of the placenta between the induction of labor and the expectant management group were seen. Fetal vascular malperfusion, villitis of unknown etiology and nucleated red blood cell count did not differ between the groups.Conclusion: Expectant management of late FGR is associated with increased maternal vascular malperfusion and chorioamnionitis. This may have implications for fetal and neonatal outcome, such as programming in the developing child influencing health outcomes later in life.

Placental metal concentrations in relation to placental growth, efficiency and birth weight

The quality of the intrauterine environment, in which the placenta plays a critical role, affects birth outcomes and lifelong health. The effect of metal contaminants on the growth and functioning of the placenta have not been widely reported but may provide insights into how metal exposures lead to these outcomes. We examined relationships between placental concentrations of cadmium (Cd), arsenic (As), mercury (Hg) and lead (Pb) and measures of placental growth and functioning (placental weight, placental efficiency (the log ratio of placental weight and birth weight), chorionic disc area and disc eccentricity) as part of the New Hampshire Birth Cohort Study (N = 1159). We additionally examined whether these associations were modified by placental concentrations of essential elements zinc (Zn) and selenium (Se). Associations were evaluated using generalized linear models. Multivariable-adjusted differences in placental weight were − 7.81 g (95% CI: −15.42, −2.48) with every ng/g increase in the Cd concentration of placenta (p-Value = 0.0009). Greater decrements in placental weight and efficiency associated with placental Cd were observed for females. For placentae with below median Zn and Se concentrations, decrements in placental weight were − 8.81 g (95% CI: −16.85, −0.76) and − 13.20 g (95% CI: −20.70, −5.70) respectively. The Cd concentration of placenta was also associated with reductions in placental efficiency both overall, and in Zn- and Se-stratified models. No appreciable differences were observed with other elements (As, Hg or Pb) and with other placental measures (chorionic disc area and disc eccentricity). In structural equation models, placental weight was a mediator in the relation between placental Cd concentration and reduced birth weight. Our findings suggest a role of interacting essential and contaminant elements on birth weight that may be mediated by changes in the growth and function of the placenta.

The Presence of Thyroid Peroxidase Antibody Is Associated with Lower Placental Weight in Maternal Thyroid Dysfunction.

Thyroid dysfunction (TD) is caused by thyroid peroxidase (TPO) antibody, as seen in Hashimoto's disease. TD is a common problem of reproductive age and may impair fetal development. Here, we determined the effect of TPO antibody on perinatal outcomes in Japanese women with TD before conception. A retrospective study involving cases of maternal TD with term singleton birth was conducted. The subjects with TD were divided into two groups according to the presence (n = 22) or absence (n = 20) of TPO antibody. The control groups matched for age, parity, and gestational weeks were selected for TPO antibody-positive (n = 44) and -negative TD subjects (n = 40), respectively. Using the standard curve of Japanese placental weight, the frequency of placental weight less than the 50th percentile (small placenta) was examined. Placental weight was lower among TPO antibody-positive TD subjects, compared with TPO antibody-negative TD subjects (p < 0.01). However, other outcomes were similar between the groups. Importantly, compared with control mothers, placental weight was significantly lower (p < 0.01), birth weight tended to be lower (p = 0.07), and the incidence of gestational diabetes mellitus was higher (p = 0.02) among TPO antibody-positive subjects. There was no significant difference in placental weight between TPO antibody-negative subjects and controls. The frequency of small placenta was significantly higher in TPO antibody-positive subjects (odds ratio: 16.7) even when considering diabetes and pregnancy induced hypertension. Thus, the presence of TPO antibody is associated with lower placental weight among Japanese women having TD.

Perbandingan Pengaruh Pemberian Ekstrak Zingiber officinale dengan Insulin terhadap Berat Plasenta pada Rattus norvegicus Model Diabetes Mellitus Pragestasional

Diabetes mellitus is a chronic disease that occurs in the community, with 1.9% prevalence of in the world is and the seventh leading cause of death in the world. It is estimated to increase up to 21.3 million by 2030 if the pattern of Diabetes management is not well developed. In 2007, the prevalence of Pregestational Diabetes Mellitus in Indonesia was 12% and had an impact on placental development that was important during pregnancy for fetal survival with placental weight as the indicator. Diabetes Mellitus pregestational therapy is insulin, however, it often causes complications. Oral hyperglycemic drugs with ginger dose extract of 500mg/kgBW significantly decreased serum glucose levels in diabetic-induced rats. Ginger extract is expected to decrease blood glucose levels so as to increase the weight of placenta. The purpose of this study was to determine the effect of insulin and ginger extract on the weight of placenta Rattus norvegicus model of diabetes mellitus. This research is an experimental research using post test only control group design. The population used in this study was pregnant Rattus norvegicus with simple random sampling. The independent variables are insulin and ginger extract and the dependent variable is the weight of placenta. Data analysis for placental weight using Kruskal Wallis was continued by Post Hoc Bonferroni test. Test results for placental weight p>α (0.63 > 0.05) mean that there is no difference in placental weight between negative control, positive control, and treatment group. The conclusion of this study is there is no significant difference between groups, however, based on mean data the weight of placenta Rattus norvegicus model of diabetes mellitus with insulin and ginger extract therapy are higher than the control group

Difference in the size of the placenta and umbilical cord between women with natural pregnancy and those with IVF pregnancy

PurposeThe purpose of this study was to compare the sizes of the placenta and umbilical cord in women with natural pregnancy versus those undergoing in vitro fertilization (IVF).MethodsOverall, 1610 cases of uncomplicated single pregnancies with vaginal delivery at ≥ 37 weeks of gestation were included in this study. The patients were divided into two groups: natural pregnancy group (n = 1453) and IVF pregnancy not including intracytoplasmic sperm injection (ICSI) treatment (n = 157). The groups were compared in terms of gestational week, maternal age, parity, maternal weight gain, prepregnancy maternal BMI, infant weight at birth, infant head circumference, placental weight, cross section of the placenta, cross section of the umbilical cord, insertion site of the umbilical cord, and umbilical cord length. Stepwise selection and multivariate logistic regression were used for statistical analysis to correct the result as an independent factor.ResultsThere was no difference in the size of the placenta and umbilical cord between women with natural pregnancy and with IVF, but the incidence of velamentous insertion of the cord was significantly increased in women with IVF pregnancy (adjusted odd ratio [AOR] 1.72, 95% confidence interval [CI] 1.08–2.72, p = 0.026).ConclusionsAlthough there is no difference in placental weight and cord size, velamentous insertion of the umbilical cord increases in IVF pregnancy and needs careful observation during the delivery process.

Quantitative changes of extravillous trophoblast cells in heavy smoker mothers compared with healthy controls

Maternal smoking during pregnancy can induce structural and functional changes in the placenta. Placentas from heavy smoker (>20 cigarettes per day) mothers and non-smoker healthy controls (n=10 in each group) were enrolled in the present case-control study. Sample selection and sectioning were performed by systematic uniform random sampling (SURS). Selected sections were stained using Masson's trichrome to estimate quantitative parameters of placental extravillous trophoblast cells (EVTs) and the number of EVTs. Differences between groups were evaluated using the Mann-Whitney U-test, with significance set at P<0.05. There was a significant difference in placental weight and the total volume of the placenta between the heavy smoker and control groups (P<0.05). The total volume of EVTs, nucleus diameter, cytoplasm diameter, the volume of the nucleus and cytoplasm and the nucleus to cytoplasm ratio of EVTs were significantly greater in the heavy smoker compared with control group (P<0.05 for all). In placentas from heavy smokers, the total number of EVTs per unit volume of placental bed were significantly greater than in the control group (P<0.05 for both). In conclusion, the findings suggest that maternal smoking could affect fetal health by changing the quantitative parameters of the placenta, and likely the invasive properties of EVTs.

Placenta, cord and membranes: a dual center validation study of midwives' classifications and notifications to the Medical Birth Registry of Norway.

A validation of data regarding the placenta, cord and membranes in Medical Birth Registry of Norway (MBRN) is lacking. Here we investigate the inter- and intra-observer agreement of observations regarding the placenta, cord and membranes to the MBRN in two institutions. We conducted a dual center validation study of data regarding placenta, cord and membranes. In the inter-observer study, 196 placentas in two institutions were examined by the attending midwife and a blinded colleague, whereas in the intra-observer study registrations by the attending midwife on 195 placentas were compared with her own registrations to the MBRN. In a separate sample consisting of 51 placental pathology reports, midwives' registrations to the MBRN were compared with the pathology report. For categorical and continuous variables, agreement was assessed by kappa value and paired sample t-test, respectively. Inter-observer agreement between two midwives for cord insertion site and bi-placenta, cord knots and vessel anomalies were good (kappa values >0.79 and >0.96, respectively). The inter- and intra-observer study showed no significant differences regarding placental weight and cord length (p = 0.31 and 0.28, p = 0.71 and 0.39, respectively). The inter-observer agreement between the pathology reports and midwives' registrations was good for gross placental and cord variants (kappa 0.73-1.0), but there were significant differences in placental weight and cord length (p < 0.0001). The results suggest that the validity of data regarding placenta and cord in the MBRN is sufficiently high to justify future large-scale epidemiologic research based on this database.