Assessment of Predictors for Placental Weight and Birth Weight Ratios from Deliveries Conducted in Pakistani Tertiary Care Hospitals

Predictors of Placental Weight and Birth Weight Ratios

Authors

  • Laila Khalid Department of Gynecology and Obstetrics, Polyclinic, Islamabad, Pakistan
  • Naushin Farooq Department of Gynecology and Obstetrics, Polyclinic, Islamabad, Pakistan
  • Mishal Maqbool Department of Gynecology and Obstetrics, Polyclinic, Islamabad, Pakistan
  • Nosheen Wahab Salman Department of Gynecology and Obstetrics, Gulab Devi Hospital, Lahore, Pakistan
  • Sadia Chaudhry Department of Gynecology and Obstetrics, Iqra Medical Complex, Lahore, Pakistan
  • Sumbal Altaf Department of Gynecology and Obstetrics, Hameed Latif Hospital, Lahore, Pakistan
  • Habib Ur Rehman Department of Medicine, Lahore General Hospital, Lahore, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v6i2.2705

Keywords:

Placental Weight, Birth to Placental Weight Ratio, Maternal Factors

Abstract

Anomalous placental morphology is associated with obstetric complications. To date, published data is not available regarding placental weights from Pakistan. The aim of the study was to obtain a reference value for placental weights in the Pakistani population and examined the predictors of birth weight to placental weight ratio an indicator of placental efficiency. Objective: To assess the predictors for placental weight and birth weight ratios in singleton pregnancies delivered at a tertiary care hospital in Pakistan. Methods: Data were collected prospectively for the study cohort at a tertiary care hospital unit in Islamabad, Pakistan. Placental and birth weight obtained and documented immediately post-delivery. Information about maternal factors was obtained from medical records. A linear regression model was employed to predict the effects of various risk factors on BW:PW. Results: Fetal weight varied from 2 to 4.5 kg with a mean of 3.016 ± 0.445 kg whereas mean placental weight was 0.667 kg (SD = 0.175). Fetal placental weight ratio (FPWR) existed in the range of 2.54 to 7.91 (mean = 4.732 ± 1.082). Anemia, p < 0.001 and pregnancy-induced hypertension p=0.001, can influence the weight of the placenta. Conclusion: The average placental weight reference values obtained represented the diverse multi-ethnic population residing in Islamabad, Pakistan. The correlation between placental weight and the birth weight to placental weight ratio offered valuable insights into how the placenta adapted to the various challenges posed by the various stages of pregnancy

References

Odendaal HJ. Strong Association Between Placental Pathology and Second-trimester Miscarriage. Arch Obstet Gynaecol. 2021;2(3):51-56. PMID: 34557867; PMCID: PMC8457358. DOI: https://doi.org/10.33696/Gynaecology.2.019

Cindrova-Davies T, Sferruzzi-Perri AN. Human placental development and function. Semin Cell Dev Biol. 2022 Nov;131:66-77. doi: 10.1016/j.semcdb.2022.03.039. DOI: https://doi.org/10.1016/j.semcdb.2022.03.039

Bartels HC, Hameed S, Young C, Nabhan M, Downey P, Curran KM, McCormack J, Fabre A, Kolch W, Zhernovkov V, Brennan DJ. Biological comparisons between pre-eclampsia and placenta accreta spectrum. npj Women's Health. 2024 Aug 30;2(1):30. doi.org/10.1038/s44294-024-00034-y DOI: https://doi.org/10.1038/s44294-024-00034-y

Cohen Y, Gutvirtz G, Avnon T, Sheiner E. Chronic Hypertension in Pregnancy and Placenta-Mediated Complications Regardless of Preeclampsia. J Clin Med. 2024 Feb 16;13(4):1111. doi: 10.3390/jcm13041111.. DOI: https://doi.org/10.3390/jcm13041111

Sathasivam R, Selliah P, Sivalingarajah R, Mayorathan U, Munasinghe BM. Placental weight and its relationship with the birth weight of term infants and body mass index of the mothers. J Int Med Res. 2023 May;51(5):3000605231172895. doi: 10.1177/03000605231172895.

Zhang K, Jia X, Yu W, Cheng X, Li Y, Wang X, Wang J, Li Z, Mao Y, Zhao J, Li T, Chen M, Gao G, Hu C, Yan S, Zhang X. The associations of gestational weight gain and midpregnancy lipid levels with placental size and placental-to-birth weight ratio: findings from a chinese birth cohort study. BMC Pregnancy Childbirth. 2023 Oct 11;23(1):725. doi: 10.1186/s12884-023-05991-x. DOI: https://doi.org/10.1186/s12884-023-05991-x

Mitsuda N, Awn JN, Eitoku M, Maeda N, Fujieda M, Suganuma N et al. Association between maternal active smoking during pregnancy and placental weight: The Japan environment and Children's study. Placenta. 2020 May; 94: 48-53. doi: 10.1016/j.placenta.2020.04.001. DOI: https://doi.org/10.1016/j.placenta.2020.04.001

Sferruzzi-Perri AN, Lopez-Tello J, Salazar-Petres E. Placental adaptations supporting fetal growth during normal and adverse gestational environments. Exp Physiol. 2023 Mar;108(3):371-397. doi: 10.1113/EP090442. DOI: https://doi.org/10.1113/EP090442

Puia-Dumitrescu M, Sullivan LN, Tanaka D, Fisher K, Pittman R, Kumar KR, Malcolm WF, Gustafson KE, Lodge AJ, Goldberg RN, Hornik CP. Survival, Morbidities, and Developmental Outcomes among Low Birth Weight Infants with Congenital Heart Defects. Am J Perinatol. 2021 Nov;38(13):1366-1372. doi: 10.1055/s-0040-1712964. DOI: https://doi.org/10.1055/s-0040-1712964

Huang Z, Zhang Y, Wang J, Tan X, Zhang A. Impact of maternal age on birth weight-related adverse outcomes in newborns: a retrospective study in south-central China. BMC Pregnancy and Childbirth. 2025 Jan 30;25(1):92. doi.org/10.1186/s12884-025-07199-7 DOI: https://doi.org/10.1186/s12884-025-07199-7

Strøm-Roum EM, Jukic AM, Eskild A. Offspring birthweight and placental weight-does the type of maternal diabetes matter? A population-based study of 319 076 pregnancies. Acta Obstet Gynecol Scand. 2021 Oct;100(10):1885-1892. doi: 10.1111/aogs.14217. DOI: https://doi.org/10.1111/aogs.14217

Arabzadeh H, Doosti-Irani A, Kamkari S, Farhadian M, Elyasi E, Mohammadi Y. The maternal factors associated with infant low birth weight: an umbrella review. BMC Pregnancy and Childbirth. 2024 Apr 25;24(1):316. doi.org/10.1186/s12884-024-06487-y DOI: https://doi.org/10.1186/s12884-024-06487-y

Richardson BS, Rajagopaul A, de Vrijer B, Eastabrook G, Regnault TR. Fetal sex impacts birth to placental weight ratio and umbilical cord oxygen values with implications for regulatory mechanisms. Biology of sex Differences. 2022 Jun; 13(1): 35. doi: 10.1186/s13293-022-00445-z.

Hochler H, Lipschuetz M, Suissa-Cohen Y, Weiss A, Sela HY, Yagel S, Rosenbloom JI, Grisaru-Granovsky S, Rottenstreich M. The Impact of Advanced Maternal Age on Pregnancy Outcomes: A Retrospective Multicenter Study. J Clin Med. 2023 Sep 1;12(17):5696. doi: 10.3390/jcm12175696. PMID: 37685763; PMCID: PMC10488955. DOI: https://doi.org/10.3390/jcm12175696

Christopher Flatley, Pol Sole-Navais, Marc Vaudel, Øyvind Helgeland, Dominika Modzelewska, Stefan Johansson, Bo Jacobsson, Pål Njølstad, Placental weight centiles adjusted for age, parity and fetal sex. Placenta.2022; 117: 87-94,https://doi.org/10.1016/j.placenta.2021.10.011. DOI: https://doi.org/10.1016/j.placenta.2021.10.011

Eskild A, Romundstad PR, Vatten LJ. Placental weight and birthweight: does the association differ between pregnancies with and without preeclampsia?. American Journal of Obstetrics and Gynecology. 2009 Dec; 201(6): 595-e1. doi: 10.1016/j.ajog.2009.06.003. DOI: https://doi.org/10.1016/j.ajog.2009.06.003

Bianchi C, Taricco E, Cardellicchio M, Mandò C, Massari M, Savasi V et al. The role of obesity and gestational diabetes on placental size and fetal oxygenation. Placenta. 2021 Jan; 103: 59-63. doi: 10.1016/j.placenta.2020.10.013. DOI: https://doi.org/10.1016/j.placenta.2020.10.013

Choo S, de Vrijer B, Regnault TRH, Brown HK, Stitt L, Richardson BS. The impact of maternal diabetes on birth to placental weight ratio and umbilical cord oxygen values with implications for fetal-placental development. Placenta. 2023 May;136:18-24. doi: 10.1016/j.placenta.2023.02.008. Epub 2023 Feb 24. PMID: 37003142. DOI: https://doi.org/10.1016/j.placenta.2023.02.008

Godfrey KM, Redman CW, Barker DJ, Osmond C. The effect of maternal anaemia and iron deficiency on the ratio of fetal weight to placental weight. BJOG: An International Journal of Obstetrics & Gynaecology. 1991 Sep; 98(9): 886-91. doi: 10.1111/j.1471-0528.1991.tb13510.x. DOI: https://doi.org/10.1111/j.1471-0528.1991.tb13510.x

Benson CS, Shah A, Stanworth SJ, Frise CJ, Spiby H, Lax SJ, et al. The effect of iron deficiency and anaemia on women’s health. Anaesthesia. 2021;76(Suppl 4):84–95. 10.1111/anae.15405 DOI: https://doi.org/10.1111/anae.15405

Salavati N, Smies M, Ganzevoort W, Charles AK, Erwich JJ, Plösch T et al. The possible role of placental morphometry in the detection of fetal growth restriction. Frontiers in Physiology. 2019 Jan; 9: 1884. doi: 10.3389/fphys.2018.01884. DOI: https://doi.org/10.3389/fphys.2018.01884

Liu HJ, Liu PC, Hua J, Zhao Y, Cao J. Placental weight and size in relation to fetal growth restriction: a case-control study. The Journal of Maternal-Fetal & Neonatal Medicine. 2021 May; 34(9): 1356-60. doi: 10.1080/14767058.2019.1636371. DOI: https://doi.org/10.1080/14767058.2019.1636371

Richardson BS, Rajagopaul A, de Vrijer B, Eastabrook G, Regnault TR. Fetal sex impacts birth to placental weight ratio and umbilical cord oxygen values with implications for regulatory mechanisms. Biology of sex Differences. 2022 Jun; 13(1): 35. doi: 10.1186/s13293-022-00445-z DOI: https://doi.org/10.1186/s13293-022-00445-z

Adeniran AS, Adesina KT, Ezeoke GG, Fawole AA, Aboyeji AP, Ijaiya MA. Relationship between placental weight, birth weight, maternal biosocial characteristics and placental-to-birth-weight ratio. Medical Journal of Zambia. 2020 Mar; 47(4): 281-7. doi: 10.55320/mjz.47.4.121. DOI: https://doi.org/10.55320/mjz.47.4.121

Sathasivam R, Selliah P, Sivalingarajah R, Mayorathan U, Munasinghe BM. Placental weight and its relationship with the birth weight of term infants and body mass index of the mothers. Journal of International Medical Research. 2023 May; 51(5): 03000605231172895. doi: 10.1177/03000605231172895 DOI: https://doi.org/10.1177/03000605231172895

Dypvik J, Larsen S, Haavaldsen C, Saugstad OD, Eskild A. Placental Weight and Risk of Neonatal Death. JAMA Pediatr. 2020;174(2):197–199. doi:10.1001/jamapediatrics.2019.4556 DOI: https://doi.org/10.1001/jamapediatrics.2019.4556

Galofré‐Vilà G and Harris B. Growth before birth: the relationship between placental weights and infant and maternal health in early twentieth‐century Barcelona. The Economic History Review. 2021 May; 74(2): 400-23. doi: 10.1111/ehr.13026. DOI: https://doi.org/10.1111/ehr.13026

Al Fahdi, M., Riyami, N.A. & Ahmed, B. Placental histopathological abnormalities in adverse obstetric outcomes: a retrospective cross-sectional study at Sultan Qaboos University Hospital. BMC Women's Health.2024 ; 24 613 https://doi.org/10.1186/s12905-024-03447-8 DOI: https://doi.org/10.1186/s12905-024-03447-8

O'Brien O, Higgins MF, Mooney EE. Placental weights from normal deliveries in Ireland. Irish Journal of Medical Science (1971-). 2020 May; 189: 581-3. doi: 10.1007/s11845-019-02102-8. DOI: https://doi.org/10.1007/s11845-019-02102-8

Kafle R, Nibedita K, Gupta BK. Mean birth weight and mean placental weight among deliveries in a tertiary care hospital. JNMA: Journal of the Nepal Medical Association. 2019 Sep; 57(219): 364. doi: 10.31729/jnma.3660. DOI: https://doi.org/10.31729/jnma.3660

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Published

2025-02-28

How to Cite

Khalid, L., Farooq, N., Maqbool, M., Salman, N. W., Chaudhry, S., Altaf, S., & Rehman, H. U. (2025). Assessment of Predictors for Placental Weight and Birth Weight Ratios from Deliveries Conducted in Pakistani Tertiary Care Hospitals: Predictors of Placental Weight and Birth Weight Ratios . Pakistan Journal of Health Sciences, 6(2), 101–107. https://doi.org/10.54393/pjhs.v6i2.2705

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