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Minerva Obstetrics and Gynecology 2021 Nov 26

DOI: 10.23736/S2724-606X.21.04963-0


language: English

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

Marilia B. CARNEIRO 1, Amanda F. ARAUJO 1, Leandro D. SILVA 1, Caetano G. PETRINI 1, 2, Larissa M. REIS 1, Edward ARAUJO JÚNIOR 3, 4 , Alberto B. PEIXOTO 1, 2, 5

1 Department of Obstetrics and Gynecology, University of Uberaba (UNIUBE), Uberaba, Brazil; 2 Department of Obstetrics and Gynecology, Federal University of Triângulo Mineiro (UFTM), Uberaba, Brazil; 3 Department of Obstetrics, School of Medicine, Federal University of São Paulo (EPM-UNIFESP) - Paulista, São Paulo, Brazil; 4 Medical course, Municipal University of São Caetano do Sul (USCS), Bela Vista Campus, São Paulo, Brazil; 5 Fetal Medicine Unit, Sabin Diagnostic Medicine, Uberaba, Brazil


BACKGROUND: 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: I. grade 3 placenta <36 weeks, II. grade 3 placenta >36 weeks, III. no occurrence of grade 3 placenta throughout pregnancy. The chi-square 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 cutoff of the middle cerebral artery (MCA) pulsatility index (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.

KEY WORDS: Pregnancies <36 weeks; Grade 3 placenta; Adverse perinatal outcomes; Doppler

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