Get Permission Aghera and Ahmed: A study on association of placental morphometry with newborn anthropometry


Introduction

Placental advancement was perceived from fossil indication of Ichthyosaurus, in excess of 170 million years prior. Circle molded haemochorial placenta of various humans, happened all through the Eutherian ancestry.1

Chorionic plate resultant from the developing incipient organism & decidual plate resultant from a change of the uterine covering of the mother, Consequently, the human placenta develops from both uterus & creating embryo.2, 3, 4, 5 In beginning the placenta assesses the embryo in size & keeps on creating till term. As gestation propels, it grows moderately more modest & by term, the proportion of its weight to that of the baby is about 1:6 to 1:72.

The chorionic plate part expresses the placental surface part covering the uterus & depicts, the number of maternal winding courses & veins are plausible gives to surface area.6 Placental turn of events & profitability are the main fetal wellspring of supplements & oxygen flexibly. Placental improvement is around achieved by beginning third trimester, while the thickness of placenta increments in last third trimester.7, 8, 9, 10

Placental thickness, by distinction, denotes the measure of arborisation of the villous slender bed, the genuine locus of maternal-fetal trade.11 Placental volume was clearly comparative with the birth weight of the baby.12

Unordinary chorionic plate shape regularly uncovers pathologic villous decay from the finish of the principal trimester or placental infarct. Subsequently, these boundaries of placental advancement might be crucial pointers of placental load at delivery.13

Materials and Methods

The current examination was coordinated in the Department of Anatomy, Geetanjali Medical College and Hospital, Udaipur (Rajasthan) and pacific clinical school and emergency clinic Udaipur. Placentae were assembled from Obstetrics and Gynecology Unit. Data was gathered from August 2018 to November 2019. The examination was directed to 391 mothers & their singleton posterity. Information about mothers & consent was taken starting the real examination. Subjects without antenatal enrollment during the principal trimester & with history of pre-pregnancy key & industrious ailments were banished. Placental morphometry & baby limits were noted on the predesigned & pretested design.

  1. Techniques for example assortment, planning, & evaluation of placental morphometry:14 a. Placentae were assembled not long subsequent to secluding the newborn from the umbilical rope, assembled placentae were assessed inside & out washed under the running water, starting there, layers were overseen.b. The models were marked with numbers for ID & were delivered to the capacity lab by setting in a 10% formalin compartment.c. The weight of each placenta of newborn was kept constrained by the automated measuring scale CS-8316(CE guaranteed) & recorded with an exactness of 1 gm.d. The maternal surface locale of the placenta was resolved using the formula.15

  2. Boundaries of infant evaluated were:

  3. Birth weight calculated using Digital baby measuring scale CS-8316 (CE asserted) with an accuracy of 10 gm.

Statistical analysis

Statistical Analysis was carried out using Analysis of Variances and comparisons of means were studied by t-test was done utilizing SPSS-16, the Box plots were set up to examine the relative circulations placental morphometry & infant anthropometry.

Table 1

Distribution of gestation & birth weight

Variables

Percent

Cumulative Percent

Observed

Expected

a. Gestation in wks, Mean=38.3, SD=2.2

28-32

4.1

4.10

0.87

33-36

10.7

14.80

28.00

37-40

78.5

93.40

88.70

41+

6.6

100.00

100.00

Total

100

b. Birth weight in gm, Mean=2700, SD=500

1000-1499

3.6

3.6

0.8

1500-1999

3.6

7.2

8.1

2000-2499

21

28.2

34.5

2500-2999

44.5

72.6

72.6

3000-3499

22.8

95.4

94.5

3500+

4.6

100

100

Total

100

Table 2

Percentiles by birth weight groups

Newborn birth weight among groups (Mean=2700, SD=500)

Percent %(n=391)

Percentiles

5

10

25

50

75

90

95

a. Placental weight in gm

<(Mean-1SD)

11.51

201.5

227.6

272.5

342.0

426.0

500.0

559.7

(Mean±1SD)

75.70

304.9

340.5

386.0

440.0

495.8

562.9

586.0

>(Mean+1SD)

12.79

373.1

402.1

469.8

517.5

580.0

649.8

802.6

b. Placental volume in ml

<(Mean-1SD)

11.51

106.0

176.0

225.0

290.0

380.0

414.0

486.0

(Mean±1SD)

75.70

250.0

280.0

320.0

390.0

430.0

500.0

520.0

>(Mean+1SD)

12.79

300.0

371.0

420.0

470.0

520.0

609.0

746.0

c. Placental surface area in cm sq

<(Mean-1SD)

11.51

106.5

127.0

154.0

187.0

213.7

243.3

262.4

(Mean±1SD)

75.70

164.8

176.8

200.4

226.3

253.8

282.9

314.3

>(Mean+1SD)

12.79

193.8

206.8

227.1

265.6

297.4

314.2

368.2

d. Placental thickness in cm

<(Mean-1SD)

11.51

1.3

1.5

1.5

2.0

2.5

2.5

3.0

(Mean±1SD)

75.70

1.5

1.5

2.0

2.0

2.5

2.6

3.0

>(Mean+1SD)

12.79

1.5

1.6

2.0

2.1

2.5

3.0

3.0

Figure 1

Placental weight by birth weight

https://typeset-prod-media-server.s3.amazonaws.com/article_uploads/e052db70-9df8-4de9-b585-d688d0a49406/image/a3468ea3-e9c3-4f2d-8799-ccbe76a3efd1-uimage.png

Figure 2

Placental volume by birth weight

https://typeset-prod-media-server.s3.amazonaws.com/article_uploads/e052db70-9df8-4de9-b585-d688d0a49406/image/fa03650d-0590-4907-90ec-114762941948-uimage.png

Figure 3

Placental surface area by birth weight

https://typeset-prod-media-server.s3.amazonaws.com/article_uploads/e052db70-9df8-4de9-b585-d688d0a49406/image/e904a6b2-4ffa-4d2b-adb2-da61efa5a7f3-uimage.png

Table 3

Percentiles of birth weight & placental morphometry length among groups

Newborn length groups

(Mean=46.6, SD=2.5 cm)

Percent

(n=391)

Percentiles

5

10

25

50

75

90

95

a. Birth weight in gm

<(Mean-1SD)

10.49

1100

1200

1372

1800

2000

2940

3100

(Mean±1SD)

79.28

2200

2300

2500

2700

2900

3000

3200

>(Mean+1SD)

10.23

3000

3000

3100

3325

3500

3698

3924

b. Placental weight in gm

<(Mean-1SD)

10.49

196.5

225.2

261.5

334.0

430.0

511.4

560.9

(Mean±1SD)

79.28

307.2

344.4

388.0

440.0

496.0

560.0

583.5

>(Mean+1SD)

10.23

352.2

386.0

469.3

560.5

585.5

652.1

832.0

c. Placental volume in ml

<(Mean-1SD)

10.49

102.0

172.0

210.0

290.0

370.0

426.0

479.0

(Mean±1SD)

79.28

260.0

280.0

320.0

400.0

430.0

500.0

520.0

>(Mean+1SD)

10.23

300.5

341.0

420.0

500.0

527.5

607.0

782.0

d. Placental surface area in cmsq

<(Mean-1SD)

10.49

103.6

121.9

153.6

187.0

207.4

251.1

287.0

(Mean±1SD)

79.28

165.0

176.8

200.4

226.3

253.8

282.9

314.3

>(Mean+1SD)

10.23

177.3

212.3

235.7

267.1

298.5

314.2

329.5

e. Placental thickness in cm

<(Mean-1SD)

10.49

1.2

1.4

1.5

2.0

2.5

2.5

2.6

(Mean±1SD)

79.28

1.5

1.5

2.0

2.0

2.5

2.6

3.0

>(Mean+1SD)

10.23

1.5

1.5

2.0

2.0

2.5

3.0

3.0

Figure 4

Birth weight by newborn length

https://typeset-prod-media-server.s3.amazonaws.com/article_uploads/e052db70-9df8-4de9-b585-d688d0a49406/image/9d1287cf-55ee-46d5-a3e0-3578ac1d9b2e-uimage.png

Figure 5

Placental weight by newborn length

https://typeset-prod-media-server.s3.amazonaws.com/article_uploads/e052db70-9df8-4de9-b585-d688d0a49406/image/3109ab7b-cb4f-49cd-ae94-885b94f4b0ee-uimage.png

Figure 6

Placental volume by newborn length

https://typeset-prod-media-server.s3.amazonaws.com/article_uploads/e052db70-9df8-4de9-b585-d688d0a49406/image/1fe9360e-c525-4716-a0b9-6cddfe93ce50-uimage.png

Figure 7

Placental surface area by newborn length

https://typeset-prod-media-server.s3.amazonaws.com/article_uploads/e052db70-9df8-4de9-b585-d688d0a49406/image/12e37871-ab4e-4357-97d4-0893e7cf0bbd-uimage.png

Table 4

Association of placental morphometry with birth weight

Birth weight groups

N

Percent

Mean

SD

SE

95% Confidence Interval

Lower

Upper

Weight in gm;***; F2,388=49.94; p<0.001

<(Mean-1SD)

45

11.5

353.2

103.2

15.4

322.2

384.3

(Mean±1SD)

296

75.7

442.8

82.3

4.8

433.4

452.3

>(Mean+1SD)

50

12.8

533.4

103.8

14.7

503.9

562.9

Total

391

100.0

440.0

100.0

5.0

434.3

453.9

Volume in ml;***;F2,388=53.81; p<0.001

<(Mean-1SD)

45

11.5

296.1

98.8

14.7

266.4

325.8

(Mean±1SD)

296

75.7

384.2

82.8

4.8

374.7

393.6

>(Mean+1SD)

50

12.8

482.6

105.5

14.9

452.6

512.6

Total

391

100.0

384.6

101.0

5.0

376.8

396.5

Surface area in cm sq ;***; F2,388=38.13; p<0.001

<(Mean-1SD)

45

11.5

183.9

42.7

6.4

171.1

196.8

(Mean±1SD)

296

75.7

230.7

45.9

2.7

225.4

235.9

>(Mean+1SD)

50

12.8

266.1

48.8

6.9

252.2

279.9

Total

391

100.0

229.8

50.1

2.5

224.9

234.8

Thickness in cm;*;F2,388=4.12; p<0.05

<(Mean-1SD)

45

11.5

2.0

0.5

0.1

1.9

2.2

(Mean±1SD)

296

75.7

2.1

0.4

0.0

2.1

2.2

>(Mean+1SD)

50

12.8

2.3

0.8

0.1

2.1

2.5

Total

391

100.0

2.1

0.5

0.0

2.1

2.2

Table 5

Association of placental morphometry with length of newborn

Newborn length groups

Percent

Mean

SD

SE

95% Confidence Interval

Lower Bound

Upper Bound

Birth weight in gm;***;F2,388=198.0; p<0.001

<(Mean-1SD)

41

10.5

1829

576

90

1647

2011

(Mean±1SD)

310

79.3

2685

312

18

2650

2719

>(Mean+1SD)

40

10.2

3341

270

43

3255

3427

Total

391

100.0

2700

500

25

2613

2711

Weight in gm;***;F2,388=46.7; p<0.001

<(Mean-1SD)

41

10.5

348.9

107.8

16.8

314.9

382.9

(Mean±1SD)

310

79.3

444.5

82.0

4.7

435.3

453.7

>(Mean+1SD)

40

10.2

538.7

112.2

17.7

502.8

574.6

Total

391

100.0

440.0

100.0

5.0

434.3

453.9

Volume in ml;***; F2,388=48.1; p<0.001

<(Mean-1SD)

41

10.5

291.2

101.3

15.8

259.3

323.2

(Mean±1SD)

310

79.3

386.6

83.7

4.8

377.2

395.9

>(Mean+1SD)

40

10.2

485.0

112.1

17.7

449.1

520.9

Total

391

100.0

384.6

101.0

5.0

376.8

396.5

Surface area in cm sq ;***; F2,388=30.30; p<0.001

<(Mean-1SD)

41

10.5

184.5

45.9

7.2

170.0

199.0

(Mean±1SD)

310

79.3

231.4

47.0

2.7

226.1

236.6

>(Mean+1SD)

40

10.2

264.2

45.2

7.1

249.8

278.6

Total

391

100.0

229.8

50.1

2.5

224.9

234.8

Thickness in cm;*; F2,388=3.91; p<0.05

<(Mean-1SD)

41

10.5

2.0

0.4

0.1

1.8

2.1

(Mean±1SD)

310

79.3

2.1

0.5

0.0

2.1

2.2

>(Mean+1SD)

40

10.2

2.2

0.4

0.1

2.1

2.3

Total

391

100.0

2.1

0.5

0.0

2.1

2.2

Result and Discussion

Mean birth weight if there should be an event of the current assessment was 2,700 gm, lesser than all recently referenced considers, yet practically like Mysore Parthenon study as they were from similar neighborhood belt of India.16, 17, 18 Placental development is related with pregnancy results, as the placental morphology & its physiology decide the development direction of the embryo. Mean birth weight in the current assessment was nearer to that of Indian newborn children, it is decided the ideal extent of birth weight in made countries as 3000-4000 gm to keep up a key good ways from maternal & fetal mortality & morbidity19 referred to the mean & SD of birth weight of Malays, Chinese, & Indian youngsters as 3126±300gm, 3245±300gm & 2935±400gm respectively.20

In the current assessment birth weight indicated a dependably sure & tremendous connection with the going with limits: The current assessment declares the placental weight, volume, & surface domain are basic determinants of birth weight.21 Placental morphometry: Weight (p<0.001), volume (p<0.001), surface zone (p<0.001), thickness (p<0.05), baby Length (p<0.001), current examination showed 28.2% LBW kids described as under 2500 gm.

LBW was identified with an extended risk of perinatal mortality & those youngsters who suffer are slanted to have hindered immune limit, diminished muscle quality, & bear cardiovascular diseases22 so, birth weight can be used as a strong marker of newborn child unsullied perseverance.

A Norway based study declared the mean newborn child length of 50.8±SD 2.320cm. The placental weight mirrors the turn of events and capacity of the placenta and is corresponded with gestational age. The current examination indicated that placental weight expanded by birth weight and gestational age, which agrees with past perception. Another Indian assessment itemized the mean newborn child length of 47.06±1.18cm. The mean baby length from Malays 48.8 cm, Chinese 49.5 cm & Indians 48.1 cm, & assumed that Indian youngsters were more restricted than Malays & Chinese neonates.23 The mean length 48.7 cm of newborn child & uncovered an immense positive association between's the placental weight & baby length.24

Conclusion

Maternal pre-pregnancy weight mean (48.4±8.9 kg) with 14.1% of women weighing less than 40 kg. Percentiles of birth weight & placental morphometry: weight, volume, & surface area with maternal pre-pregnancy weight (p<0.001) & surface zone (p<0.05). Gestational weight gain was basically identified with birth weight (p<0.01) regardless, placental morphometry. Maternal height followed dissemination where 08.2% of pregnant women had height under 145 cm & 59.8% were from height pack 150-159 cm. The mean maternal height was 153.9±6.7cm. Percentiles of birth weight growing example with maternal height yet placental morphometry & Birth weight (p<0.05) extended dependably with the growing maternal height, nevertheless, placental morphometry didn't show any consistent association

Limitations

Placental morphometry determines the birth weight & newborn length. However, the results need further validation in other setups with a large number of subjects.

Source of Funding

None.

Conflict of Interest

The authors declare no conflict of interest.

References

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