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Review
. 2025 Feb 28;14(5):1649.
doi: 10.3390/jcm14051649.

Placental Location Site and Associated Intrapartum, Postpartum, and Neonatal Complications: A Comprehensive Review and Meta-Analysis

Dayna D Whitcombe  1 , Zhuopei Hu  2 , Songthip T Ounpraseuth  2 , Everett F Magann  1
Affiliations
Review

Placental Location Site and Associated Intrapartum, Postpartum, and Neonatal Complications: A Comprehensive Review and Meta-Analysis

Dayna D Whitcombe et al. J Clin Med. .

Abstract

Background/Objectives: Adverse intrapartum, postpartum, and neonatal complications have been linked to placenta implantations sites. However, different reviews have led to contrasting conclusions about placental locations and pregnancy outcomes. We aim to determine if there is a relationship between the placental implantation site and intrapartum, postpartum, and neonatal outcomes. Methods: The Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines were followed during this review. The literature search used PubMed, CINAHL, and Embase. Years searched was not a study limitation. Only articles in English were included. Two authors reviewed the abstracts. Results: Of 40 articles identified as specific to intrapartum, postpartum, and/or neonatal complications (with some articles overlapping categories), 19 included intrapartum complications, 19 included postpartum complications, and 22 included neonatal complications. Pregnancies with a midline placenta (compared to a lateral placenta) had a greater likelihood of macrosomia/LGA infant (odds ratio (OR), 1.52 (95% CI: 1.22-1.90)) and lesser likelihood to have non-cephalic presentation (OR, 0.17 (95% CI: 0.06-0.51)), FGR/SGA infant (OR, 0.68 (CI: 0.55-0.85)), and retained placenta (OR, 0.33 (95% CI: 0.22-0.50)). Pregnancies with a low-lying placenta (compared to within uterine corpus) were more likely to have non-elective cesarean section (OR, 1.94 (95% CI: 1.06-3.55)) and postpartum hemorrhage (OR 1.49 (95% CI: 1.12-1.97)). Conclusions: Significant associations between placental location site and intrapartum complications (non-cephalic presentation, non-elective cesarean section), postpartum complications (postpartum hemorrhage, retained placenta), and neonatal complications (FGR/SGA, Macrosomia/LGA) were identified. There were no significant associations identified between the placental location site and several neonatal complications, including Apgar < 7 at 5 min, NICU admission, IUFD, and neonatal death.

Keywords: intrapartum complications; neonatal complications; placental location; postpartum complications.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure A1
Figure A1
Intrapartum and postpartum perinatal complications [11,12,15,18,19,27,29,34,35,37,39].
Figure 1
Figure 1
Literature Review Diagram.
Figure 2
Figure 2
Intrapartum complications: non-cephalic presentation and non-elective cesarean section [6,10,13,14,15,16,18,21,23,29,31,34,35,37,38,40,42].
Figure 3
Figure 3
Postpartum complications: postpartum hemorrhage and retained placenta [7,9,11,15,17,18,28,29,30,31,33,35,37,39].
Figure 4
Figure 4
Fetal/neonatal complications: FGR/SGA and macrosomia/LGA [8,10,12,15,18,20,22,24,26,29,31,33,34,35,36,37,39].
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