A retrospective chart review was conducted of pathologic findings from singleton placentas diagnosed with VUE between 2013 and 2019. Control placentas were matched 1:1 for gestational age and presence/absence of fetal IUGR. Neonatal outcomes of interest included: newborn resuscitation, NICU admission, Apgar scores and cord blood acidosis. Odds ratio and 95 % confidence intervals were calculated with controls as the reference.
452 placentas were included. 35 % of pregnancies were complicated by IUGR. When analyzed by severity (low-grade: OR = 4.75 [2.86-8.14]; high-grade: OR = 4.76 [2.71-8.79]) and distribution (focal: OR = 5.24 [2.87-10.17]; multifocal: OR = 4.90 [2.90-8.59]), VUE was significantly associated with need for newborn resuscitation. No other neonatal outcomes of interest were significantly associated with VUE diagnosis.
We determined a statistically significant association between VUE severity and distribution and the need for newborn resuscitation. VUE lesions were not associated with any additional neonatal outcomes of interest. Further studies with larger sample sizes are required to confirm these associations for obstetric and neonatal case management.
方法:对2013年至2019年间诊断为VUE的单胎胎盘的病理结果进行回顾性分析。对照胎盘的胎龄和胎儿IUGR的存在/不存在与1:1匹配。感兴趣的新生儿结局包括:新生儿复苏,NICU入院,Apgar评分和脐带血酸中毒。以对照作为参考,计算赔率和95%置信区间。
结果:包括452个胎盘。35%的妊娠因IUGR而复杂化。当按严重程度分析时(低等级:OR=4.75[2.86-8.14];高等级:OR=4.76[2.71-8.79])和分布(焦点:OR=5.24[2.87-10.17];多焦点:OR=4.90[2.90-8.59]),VUE与新生儿复苏的需要显著相关。没有其他感兴趣的新生儿结局与VUE诊断显着相关。
结论:我们确定了VUE严重程度和分布与新生儿复苏需求之间的统计学显著关联。VUE病变与任何其他感兴趣的新生儿结局无关。需要进行更大样本量的进一步研究,以确认产科和新生儿病例管理的这些关联。