Of pregnancies complicated by small for gestational age babies at term, what proportions have placental findings with implications for future pregnancies or neonatal outcomes?

Abstract

Background: Small for gestational age (SGA) is a term to define any baby born with birth weight <10th centile. SGA can be associated with a number of placental pathology findings, which may influence maternal outcomes, neonatal neurodevelopment, and future pregnancies.

Aims: To identify the proportion of term pregnancies complicated by SGA with placental findings that may have implications for future pregnancies or neonatal outcomes.

Method: A retrospective review between 2011 and 2015 of babies and placentas born at term with SGA histopathological findings were categorized as to whether they had a high recurrence rate and where the long-term neurodevelopmental outcome may affect the neonate.

Results: Six hundred and ninety-eight babies were identified as SGA. Only 335 (47.8%) placentas were sent for histopathological assessment. Of these, 60 (17.9%) had histopathological findings associated with high recurrence rates and 68 (20.2%) had findings associated with potential adverse neonatal outcomes.

Conclusions: Of those placentas sent for examination between 17.9% and 20.2% had findings associated with either high recurrence rates or findings that may benefit from neonatal follow-up. Under 50% of pregnancies complicated by SGA at term had a placental examination, resulting in a significant number of potential important clinical consequences being missed.

Keywords:

• Small gestational age
• placenta
• term
• chronic villitis of unknown etiology
• fetal vascular malperfusion

Acknowledgments

The authors wish to acknowledge the anatomical pathology trainees and pathologists at ACT Pathology, the Canberra Hospital, who were involved in the initial assessment of the placentas.

Disclosure statement

No potential conflict of interest was reported by the authors.