The impact of lateral placenta on preeclampsia and small for gestational age neonates: a systematic review and meta-analysis

Antonios Siargkas; Ioannis Tsakiridis; Petros Grammenos; Aikaterini Apostolopoulou; Sonia Giouleka; Apostolos Mamopoulos; Apostolos Athanasiadis; Themistoklis Dagklis

doi:10.1515/jpm-2022-0118

The impact of lateral placenta on preeclampsia and small for gestational age neonates: a systematic review and meta-analysis

J Perinat Med. 2022 Oct 3;51(4):468-476. doi: 10.1515/jpm-2022-0118. Print 2023 May 25.

Authors

Antonios Siargkas¹, Ioannis Tsakiridis¹, Petros Grammenos¹, Aikaterini Apostolopoulou², Sonia Giouleka¹, Apostolos Mamopoulos¹, Apostolos Athanasiadis¹, Themistoklis Dagklis¹

Affiliations

¹ Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
² Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.

PMID: 36174088
DOI: 10.1515/jpm-2022-0118

Abstract

Objectives: We conducted a systematic review and meta-analysis to quantitatively summarize the present data on the association of prenatally identified lateral placenta in singleton pregnancies with small for gestational age (SGA) neonates, preeclampsia and other perinatal outcomes.

Methods: From inception to November 2021, we searched PubMed/Medline, Scopus and The Cochrane Library for papers comparing the risk of SGA and preeclampsia, as well as other perinatal outcomes in singleton pregnancies with a prenatally identified lateral placenta to those with non-lateral placentas. The revised Newcastle-Ottawa Scale was used to evaluate the quality of eligible papers. The I² test was employed to evaluate the heterogeneity of outcomes among the studies. To investigate the possibility of publication bias, funnel plots were constructed. Prospero RN: CRD42021251590.

Results: The search yielded 5,420 articles, of which 16 were chosen, comprising of 15 cohort studies and one case control study with a total of 4,947 cases of lateral and 96,035 of non-lateral placenta (controls) reported. SGA neonates were more likely to be delivered in cases with a lateral placenta (OR: 1.74; 95% CI: 1.54-1.96; p<0.00001; I²=47%). Likewise, placental laterality was linked to a higher risk of fetal growth restriction (OR: 2.18; 95% CI: 1.54-3.06; p<0.00001; I2=0%), hypertensive disorders of pregnancy (OR: 2.39; 95% CI: 1.65-3.51; p=0.0001; I²=80%), preeclampsia (OR: 2.92; 95% CI: 1.92-4.44; p<0.0001; I²=82%) and preterm delivery (OR: 1.65; 95% CI: 1.46-1.87; p<0.00001; I²=0%).

Conclusions: The prenatal diagnosis of a lateral placenta appears to be associated with a higher incidence of preeclampsia, fetal growth restriction, preterm delivery and SGA. This may prove useful in screening for these conditions at the second trimester anomaly scan.

Keywords: Apgar; NICU; birthweight; fetal growth restriction (FGR); hypertensive disorders; lateral placenta; outcome; preeclampsia; preterm delivery; small for gestational age (SGA).

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Case-Control Studies
Female
Fetal Growth Retardation / epidemiology
Gestational Age
Humans
Infant, Newborn
Infant, Small for Gestational Age
Placenta
Pre-Eclampsia* / epidemiology
Pregnancy
Premature Birth* / epidemiology
Premature Birth* / etiology