Placental lesion multiplicity: risk factor for IUGR and neonatal cranial ultrasound abnormalities

Objective: To determine whether placental lesions are risk factors for neur ologic morbidities in intrauterine growth restricted (IUGR) infants, we com pared the incidence of cranial ultrasound (CUS) abnormalities and the numbe r and type of placental lesions in IUGR cases and gestational age-matched a ppropriate for gestational age (AGA) controls. Study design: Retrospective case-control study of 94 singleton IUGR and 145 AGA infants. Medical records, CUS reports, and placental histology were re viewed. Analyses included chi (2), t-test, analysis of variance and logisti c regressions to identify those variables significantly associated with IUG R and those associated with CUS abnormalities. Results: The incidence of CUS abnormalities was 1.7-fold higher in IUGR cas es (50%) than controls (29.7%) (p<0.05). A total placental lesion score of <greater than or equal to>3 was associated with an increased risk for IUGR (OR 14.18, 3.41-58.99; p<0.001) and increased risk for CUS abnormality (OR 12.571, 3.33-47.416;p<0.05). In a logistic regression model only greater th an or equal to2 placental lesions, IUGR and gestational age <30 weeks were significant independent predictors of CUS abnormalities. Conclusions: The severity of placental abnormalities expressed as the cumul ative number of placental lesions is a si,significant risk factor for IUGR and perinatal brain injury. These results suggest that abnormal uteroplacen tal or fetoplacental blood flow may adversely affect intrauterine growth an d increase the risk for brain injury. <(c)> 2001 Elsevier Science Ireland L td. All rights reserved.