Table 3. Selected Placental Findings for Singleton Pregnancies, Stillbirth Compared With Live Birth within Groups Defined by Gestational Age at Delivery (Completed Weeks).
| CHARACTERISTICS | Delivery <24 Weeks | Delivery 24-31 Weeks | Delivery 32-36 Weeks | Delivery ≥37 Weeks | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
| ||||||||||||
| SB nw=175 % | LB nw=74 % | OddsRatio (95% CI) | SB nw=142 % | LB nw=47 % | Odds Ratio (95% CI) | SB nw=105 % | LB nw=74 % | Odds Ratio (95% CI) | SB nw=96 % | LB nw=878 % | Odds Ratio (95% CI) | |
|
| ||||||||||||
| DEVELOPMENTAL DISORDERS | ||||||||||||
|
| ||||||||||||
| Umbilical Cord | ||||||||||||
|
| ||||||||||||
| Single umbilical artery | 7.5 | 4.2 | 1.87 (0.47, 7.50) | 8.9 | 0.0 | p<0.001* | 9.2 | 1.8 | 5.69 (1.17, 27.57) | 4.9 | 1.7 | 2.93 (1.03, 8.37) |
|
| ||||||||||||
| Velamentous insertion† | 7.0 | 0.0 | p<0.019* | 2.5 | 6.0 | 0.40 (0.09, 1.82) | 7.6 | 1.9 | 4.32 (0.51, 36.31) | 2.1 | 1.0 | 2.06 (0.44, 9.68) |
|
| ||||||||||||
| Furcate insertion† | 1.2 | 4.1 | 0.29 (0.04, 1.92) | 0.8 | 0.0 | p<0.446* | 3.5 | 3.7 | 0.95 (0.18, 5.10) | 2.6 | 3.6 | 0.72 (0.17, 3.11) |
|
| ||||||||||||
| Placental Membranes | ||||||||||||
|
| ||||||||||||
| Circummarginate‡ | 9.6 | 13.9 | 0.65 (0.26, 1.62) | 14.7 | 6.0 | 2.70 (0.97, 7.53) | 13.2 | 10.1 | 1.35 (0.52, 3.51) | 12.0 | 10.7 | 1.13 (0.60, 2.13) |
|
| ||||||||||||
| Circumvallate‡ | 2.7 | 6.2 | 0.42 (0.10, 1.67) | 3.6 | 3.7 | 0.96 (0.17, 5.43) | 1.2 | 1.6 | 0.73 (0.04, 11.98) | 1.6 | 1.3 | 1.24 (0.27, 5.70) |
|
| ||||||||||||
| Fetal Villous Capillaries | ||||||||||||
|
| ||||||||||||
| Terminal villous immaturity (diffuse) | 11.9 | 7.9 | 1.57 (0.59, 4.13) | 9.0 | 2.7 | 3.61 (0.97, 13.44) | 7.3 | 3.2 | 2.41 (0.59, 9.93) | 12.3 | 2.2 | 6.35 (2.90, 13.94) |
|
| ||||||||||||
| Terminal villous hypoplasia (diffuse) | 1.4 | 0.0 | p<0.467* | 5.8 | 11.5 | 0.48 (0.14, 1.66) | 5.1 | 2.9 | 1.82 (0.28, 11.58) | 1.0 | 1.6 | 0.60 (0.08, 4.68) |
|
| ||||||||||||
| INFLAMMATORY DISORDERS | ||||||||||||
|
| ||||||||||||
| Maternal Inflammatory Response | ||||||||||||
|
| ||||||||||||
| Acute chorioamnionitis – placental membranes | 43.0 | 79.1 | 0.20 (0.10, 0.38) | 22.1 | 32.3 | 0.59 (0.32, 1.12) | 21.6 | 14.6 | 1.61 (0.54, 4.79) | 29.2 | 11.3 | 3.24 (1.97, 5.32) |
|
| ||||||||||||
| Acute chorioamnionitis – chorionic plate | 35.7 | 82.3 | 0.12 (0.06, 0.24) | 12.5 | 23.2 | 0.47 (0.23, 0.98) | 14.7 | 18.0 | 0.79 (0.29, 2.14) | 25.7 | 11.0 | 2.79 (1.68, 4.64) |
|
| ||||||||||||
| Fetal Inflammatory Response | ||||||||||||
|
| ||||||||||||
| Acute funisitis | 22.2 | 42.9 | 0.38 (0.20, 0.72) | 3.9 | 19.1 | 0.17 (0.06, 0.46) | 0.7 | 1.8 | 0.39 (0.03, 4.38) | 4.1 | 3.1 | 1.34 (0.45, 4.02) |
|
| ||||||||||||
| Acute umbilical cord arteritis (one or more arteries) | 9.0 | 30.3 | 0.23 (0.10, 0.52) | 0.0 | 12.4 | p<0.001* | 0.9 | 1.5 | 0.61 (0.05, 7.11) | 0.8 | 1.7 | 0.47 (0.06, 3.65) |
|
| ||||||||||||
| Acute umbilical cord phlebitis | 10.2 | 25.7 | 0.33 (0.15, 0.73) | 1.4 | 11.2 | 0.11 (0.02, 0.55) | 0.9 | 3.5 | 0.26 (0.03, 2.40) | 5.0 | 2.9 | 1.75 (0.64, 4.79) |
|
| ||||||||||||
| Chorionic plate acute vasculitis | 16.7 | 61.4 | 0.13 (0.07, 0.24) | 2.8 | 14.9 | 0.17 (0.05, 0.54) | 1.8 | 4.0 | 0.43 (0.07, 2.84) | 5.7 | 5.0 | 1.15 (0.47, 2.82) |
|
| ||||||||||||
| Chorionic plate vascular degenerative changes | 5.6 | 9.1 | 0.59 (0.17, 2.12) | 6.9 | 0.0 | p<0.002* | 5.6 | 0.0 | p<0.027* | 4.2 | 0.5 | 9.16 (2.19, 38.39) |
|
| ||||||||||||
| Villitis | ||||||||||||
|
| ||||||||||||
| Acute diffuse villitis | 0.5 | 0.0 | p<0.908* | 1.8 | 0.7 | 2.86 (0.29, 28.41) | 0.0 | 0.0 | not defined* | 0.0 | 0.1 | p<0.231* |
|
| ||||||||||||
| Chronic diffuse villitis | 0.6 | 0.0 | p<0.997* | 1.8 | 6.3 | 0.27 (0.06, 1.32) | 2.1 | 0.0 | p<0.257* | 2.4 | 0.5 | 5.41 (0.97, 30.26) |
|
| ||||||||||||
| CIRCULATORY DISORDERS | ||||||||||||
|
| ||||||||||||
| Maternal Circulatory Disorders | ||||||||||||
|
| ||||||||||||
| Retroplacental hematoma | 36.2 | 36.6 | 0.98 (0.53, 1.83) | 23.2 | 9.2 | 2.99 (1.01, 8.88) | 20.2 | 3.9 | 6.28 (1.76, 22.37) | 6.1 | 4.1 | 1.53 (0.62, 3.81) |
|
| ||||||||||||
| Parenchymal Infarction§ | ||||||||||||
| Focal | 9.4 | 7.1 | 1.44 (0.48, 4.32) | 12.6 | 8.8 | 1.59 (0.50, 5.05) | 19.9 | 6.9 | 3.99 (1.36, 11.66) | 17.5 | 11.7 | 1.68 (0.94, 2.99) |
| Multifocal | 6.6 | 1.7 | 4.13 (0.52, 32.67) | 16.2 | 22.4 | 0.80 (0.35, 1.82) | 14.8 | 5.1 | 4.02 (1.21, 13.38) | 7.3 | 4.1 | 1.96 (0.87, 4.44) |
| Diffuse | 0.0 | 0.0 | not defined* | 9.0 | 0.0 | p<0.0001* | 1.8 | 0.0 | p<0.216* | 0.0 | 0.1 | p<0.112* |
|
| ||||||||||||
| Intraparenchymal thrombus | 15.1 | 12.0 | 1.30 (0.55, 3.12) | 18.0 | 16.1 | 1.14 (0.51, 2.58) | 22.7 | 10.9 | 2.40 (0.97, 5.97) | 27.3 | 13.5 | 2.41 (1.45, 3.98) |
|
| ||||||||||||
| Perivillous/intervillous fibrin/fibrinoid deposition (diffuse) | 8.2 | 12.0 | 0.66 (0.25, 1.70) | 12.5 | 4.8 | 2.85 (0.80, 10.16) | 11.5 | 2.6 | 4.94 (1.03, 23.70) | 3.8 | 1.3 | 2.92 (0.78, 10.90) |
|
| ||||||||||||
| Fetal Circulatory Disorders | ||||||||||||
|
| ||||||||||||
| Fetal vascular thrombi in the chorionic plate | 15.6 | 18.0 | 0.84 (0.35, 2.00) | 22.2 | 10.9 | 2.32 (0.87, 6.21) | 25.9 | 12.3 | 2.48 (1.05, 5.86) | 34.6 | 6.4 | 7.69 (4.56, 12.96) |
|
| ||||||||||||
| Avascular villi | ||||||||||||
| Focal | 5.5 | 8.8 | 0.66 (0.19, 2.26) | 5.3 | 0.0 | p<0.003* | 8.5 | 4.4 | 2.06 (0.51, 8.37) | 13.5 | 5.0 | 3.08 (1.64, 5.78) |
| Multifocal | 7.0 | 6.2 | 1.20 (0.37, 3.84) | 12.7 | 3.7 | 4.34 (0.91, 20.70) | 4.1 | 5.0 | 0.87 (0.22, 3.50) | 4.8 | 1.7 | 3.13 (1.02, 9.57) |
| Diffuse | 6.2 | 0.0 | p<0.022* | 5.5 | 0.0 | p<0.003* | 1.8 | 0.0 | p<0.307* | 0.0 | 0.0 | not defined* |
|
| ||||||||||||
| Edema (Placental Hydrops) | 10.9 | 12.7 | 0.84 (0.36, 1.98) | 5.0 | 4.3 | 1.18 (0.34, 4.06) | 0.9 | 2.4 | 0.35 (0.04, 3.45) | 6.4 | 0.8 | 8.12 (2.71, 24.35) |
Data are boldface where p<.05.
SB, stillbirth; LB, live birth; nw, weighted sample size; CI = confidence interval
*
Comparisons for which a placental characteristic is absent for one or both groups (SB and LB). A p-value provided in this circumstance is an upper bound as described in the text.
†
Includes umbilical cords with both velamentous and furcate insertion (<24 weeks, SB, 0.0%; LB, 0.0%; 24-31 weeks, SB, 0.0%, LB 0.0%; 32-36 weeks, SB 0.9%, LB 0.0%; ≥37 weeks, SB, 1.1%, LB 0.2%).
‡
Includes membranes with both circummarginate and circumvallate insertion (<24 weeks, SB, 0.0%; LB, 2.2%; 24-31 weeks, SB, 1.9%, LB 1.3%; 32-36 weeks, SB 0.0%, LB 1.6%; ≥37 weeks, SB, 0.7%, LB 0.4%).
§
Reference group is no parenchymal infarction.
Reference group is no avascular villi.