Placenta weight in pre-eclampsia

Abstract

Objective: Preterm and term pre-eclampsia may differ in etiology. This could be reflected in differences in placenta weight. Therefore, we compared placenta weight in pregnancies with preterm or term pre-eclampsia to placenta weight in pregnancies without pre-eclampsia.

Design: Population study.

Setting: Medical Birth Registry of Norway.

Population: All singleton pregnancies in Norway from 1999 through 2004 delivered at or after 21 weeks' gestation (n=317,688).

Methods: Placenta weight in pregnancies without pre-eclampsia (n=304,875) was compared to placenta weight in pregnancies with preterm pre-eclampsia (delivery before week 37 of pregnancy, n=3,070) and term pre-eclampsia (delivery on or after week 37 of pregnancy, n=9,743). Placenta weight z-scores were calculated to adjust for offspring sex and length of gestation, and grouped in tenths. Placenta weight according to pre-eclampsia status is presented as proportions within each tenth.

Main outcome measures: Pre-eclampsia status.

Results: In preterm pre-eclampsia, placentas were over-represented in the two lowest (33.8%; 95% CI 32.1-35.5) and under-represented in the two highest (13.1%; 95% CI 11.9-14.3) tenths of placenta weight compared to pregnancies without pre-eclampsia (20%). In term pre-eclampsia, placentas were over-represented in the two lowest (22.0%; 95% CI 21.2-22.8) and the two highest (22.7%; 95% CI 21.9-23.6) placenta weight groups. Mean placenta weight z-score was higher in term pre-eclampsia compared to pregnancies without pre-eclampsia.

Conclusions: Small placentas were associated with pre-eclampsia, and more strongly with preterm than term pre-eclampsia. In term pre-eclampsia, the association with placenta weight was u-shaped, yielding higher proportions of both low and high placenta weight compared to pregnancies without pre-eclampsia.