Effect of grade 3 placenta <36 weeks of pregnancy on perinatal outcomes.

BACKGROUND

The aim of this study was to assess whether the presence of grade 3 placenta <36 weeks of pregnancy is associated with adverse perinatal outcomes.

METHODS

Retrospective cohort study in which patients were separated into the following three groups: 1) grade 3 placenta <36 weeks, 2) grade 3 placenta >36 weeks, 3) no occurrence of grade 3 placenta throughout pregnancy. The χ2 and general linear model tests were used to compare adverse perinatal outcomes. Binary logistic regression model was used to estimate the odds ratio (OR) for adverse perinatal outcomes. Receiver operating characteristic (ROC) curve was used to determine the cut-off of the middle cerebral artery Pulsatility Index (MCA PI) in the detection of births <37 weeks in grade 3 placentas <36 weeks.

RESULTS

Significant association was observed between grade 3 placenta <36 weeks and birth <37 weeks (P<0.001), birth weight <10th percentile (P=0.001), 5-min Apgar Score <7 (P=0.014), admission to neonatal intensive care unit (P<0.001), and fetal death (P=0.002). Grade 3 placenta <36 weeks was significant predictor for birth <37 weeks (OR: 2.6; 95% CI: 1.74-3.92), pre-eclampsia (OR: 1.8; 95% CI: 1.02-3.27), birth weight <10th percentile (OR: 2.1; 95% CI: 1.39-3.10), fetal death (OR: 5.6; 95% CI: 1.65-18.78), and composite perinatal outcomes (OR: 2.2; 95% CI: 1.51-3.17). The MCA PI showed an area under ROC curve of 0.641 (95% CI: 0.546-0.728) in the detection of births <37 weeks.

CONCLUSIONS

Grade 3 placenta <36 weeks was associated with a higher prevalence of adverse perinatal outcomes.