Pregnancy Complications, Correlation With Placental Pathology and Neonatal Outcomes

Maria Teresa Loverro; Edoardo Di Naro; Vittorio Nicolardi; Leonardo Resta; Salvatore Andrea Mastrolia; Federico Schettini; Manuela Capozza; Matteo Loverro; Giuseppe Loverro; Nicola Laforgia

doi:10.3389/fcdhc.2021.807192

Pregnancy Complications, Correlation With Placental Pathology and Neonatal Outcomes

Front Clin Diabetes Healthc. 2022 Mar 8:2:807192. doi: 10.3389/fcdhc.2021.807192. eCollection 2021.

Affiliations

¹ Department of Biomedical Science and Human Oncology, Section of Neonatology and Neonatal Intensive Care, Azienda Ospedaliero-Universitaria Policlinico di Bari, School of Medicine, University of Bari "Aldo Moro", Bari, Italy.
² Department Interdisciplinary Medicine, Unit of Obstetrics and Gynecology, Azienda Ospedaliero-Universitaria Policlinico di Bari, School of Medicine, University of Bari "Aldo Moro", Bari, Italy.
³ Department of Economics and Finance University of Bari "Aldo Moro", Bari, Italy.
⁴ Department Emergency and Organ Transplantation, Institute of Pathology, Azienda Ospedaliero-Universitaria Policlinico di Bari, School of Medicine, University of Bari "Aldo Moro", Bari, Italy.
⁵ Department of Obstetrics and Gynecology, Ospedale dei Bambini "Vittore Buzzi", University of Milan, Milan, Italy.
⁶ Department of Women and Child Health, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.

Abstract

Purpose: We aimed to clarify and contribute to a better comprehension of associations and correlations between placental histological findings, pregnancy evolution, and neonatal outcomes.

Study design: This is a longitudinal and prospective observational study, performed between May 2015 and May 2019, on 506 pregnant women. Clinical data related to pregnancy outcome, neonatal health status, and placental histology were primarily collected. Twin pregnancies or malformed newborns were excluded and therefore the study was conducted on 439 cases. These cases have been then subdivided into the following study groups: (a) 282 placentas from pathological pregnancies; and, (b) a control group of 157 pregnancies over 33 weeks of gestational age, defined as physiological or normal pregnancies due to the absence of maternal, fetal, and early neonatal pathologies, most of which had undergone elective cesarean section for maternal or fetal indication.

Results: A normal placenta was present in 57.5% of normal pregnancies and in 42.5% of pathological pregnancies. In contrast, placental pathology was present in 26.2% of normal pregnancies and 73.8% of pathological pregnancies. Comparison of the neonatal health status with the pregnancy outcome showed that, among the 191 newborns classified as normal, 98 (51.3%) were born from a normal pregnancy, while 93 (48.7%) were born from mothers with a pathological pregnancy. Among the 248 pathological infants, 59 (23.8%) were born from a mother with a normal pregnancy, while 189 (76.2%) were born from pregnancies defined as pathological.

Conclusion: Placental histology must be better understood in the context of natural history of disease. Retrospective awareness of placental damage is useful in prevention in successive pregnancy, but their early identification in the evolving pregnancy could help in association with biological markers or more sophisticated instruments for early diagnosis.

Keywords: great obstetrical syndromes; high-risk pregnancy; low-risk pregnancy; neonatal outcome; placenta.