Birth weight to placenta weight ratio and its relationship to ultrasonic measurements, maternal and neonatal morbidity: A prospective cohort study of nulliparous women

• Published in: Placenta (Eastbourne) Vol. 63; pp. 45 - 52
• Main Authors: Salavati, N., Gordijn, S.J., Sovio, U., Zill-E-Huma, R., Gebril, A., Charnock-Jones, D.S., Scherjon, S.A., Smith, G.C.S.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-03-2018
• Subjects: Adult; Birth weight; Birth Weight - physiology; Doppler flow velocimetry; Female; Fetal growth; Human; Humans; Organ Size - physiology; Parity - physiology; Placenta - anatomy & histology; Placenta - diagnostic imaging; Placenta weight; Pregnancy; Prospective Studies; Ultrasonography, Prenatal; Umbilical Arteries - diagnostic imaging; Uterine Artery - diagnostic imaging; Fetal growth; Human; Doppler flow velocimetry; AC; UtA; CI; LGA; PW; UmA; SGA; GV; FGR; POP; SD; Placenta weight; BW; EFW; PI; Birth weight; GA; AGA
• ISSN: 0143-4004; 1532-3102
• DOI: 10.1016/j.placenta.2017.11.008

Birth weight to placenta weight (BWPW)-ratio is an indicator of the ability of the placenta to maintain adequate nutrient supply to the fetus. We sought to investigate the relationship between BWPW-ratio with fetal growth, utero-placental Doppler and neonatal and maternal morbidity.
We studied a group of 3311 women recruited to a prospective cohort study of nulliparous women (Rosie Hospital, Cambridge, UK) who delivered a live born infant at term and whose placental weight and birth weight were known. Ultrasonic indices and BWPW ratio were converted to gestational age adjusted z scores. Analysis of continuous variables was by multivariable linear regression. BWPW ratio was also categorized (lowest or highest quintile, both referent to quintiles 2 to 4) and associations with adverse outcomes analyzed using multivariable logistic regression.
Lowest quintile of BWPW-ratio was associated (adjusted odds ratio [95% CI], P) with both neonatal morbidity (1.55 [1.12–2.14], 0.007) and maternal diabetes (1.75 [1.18–2.59], 0.005). Highest quintile of BWPW ratio was associated with a reduced risk of maternal obesity (0.71 [0.53 to 0.95], 0.02) and preeclampsia (0.51 [0.31 to 0.84], 0.008), but higher (adjusted z score [95% CI], P) uterine artery Doppler mean pulsatility index (PI) at 20 weeks of gestation (0.09 [0.01–0.18], 0.04) and umbilical artery Doppler PI at 36 weeks of gestation (0.16 [0.07–0.25], <0.001).
BWPW-ratio is related to ultrasonic measurements and both neonatal and maternal morbidity. Therefore, this ratio may be an indicative marker of immediate and longer term health risks for an individual.
•Low BWPW-ratio was associated with neonatal and maternal morbidity.•High BWPW-ratio was associated with higher uterine and umbilical artery PI.•BWPW-ratio may be an indicative marker of health risks for an individual.