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Reproductive Sciences
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Perinatal Morbidity and Placental Size in Gestational Impaired Glucose Tolerance

Terence T. Lao, MBBS, FRCOG

Department of Obstetrics and Gynaecology, The University of Hong Kong, and Department of Obstetrics and Gynaecology, Tsan Yuk Hospital, Hong Kong, People's Republic of China; Department of Obstetrics and Gynaecology, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong, PRC, laotth{at}hkucc.hku.hk

Lai-Fong Ho, BSc

Department of Obstetrics and Gynaecology, The University of Hong Kong, and Department of Obstetrics and Gynaecology, Tsan Yuk Hospital, Hong Kong, People's Republic of China

OBJECTIVE: The clinical significance of large placentas in diabetic pregnancies is not known. A retrospective study was performed to determine whether a disproportionately large placenta, as represented by a high ratio of placental weight to birth weight (placental ratio), in pregnancies complicated by the World Health Organization category of impaired glucose tolerance (IGT), was associated with perinatal morbidity.

METHODS: We categorized 1472 consecutive singleton pregnancies with gestational IGT as having a high placental ratio (>0.2095 or mean plus one standard deviation of the value establishedfor appropriate-for-gestational age infants from nondiabetic pregnancies in a previous study) or a normnal ratio. Maternal characteristics and glycemic parameters, infant birth weight and neonatal complications, and placental weight were compared between these two groups.

RESULTS: A high placental ratio was found in 400 (27.2%) pregnancies. This group had similar maternal anthropometric and glycemic parameters, exceptfor a slightly higher prepregnancy body mass index and fastingglucose level in the oralglucose tolerance test. The high placental ratio wasfrom increased placental weight rather than the decreased birth weight. The neonates had increased incidence of low 1-minute Apgar score, treatment for neonatal jaundice and infection, and respiratory complications. After adjusting for the effects of preterm birth and vaginal delivery, a high ratio was still associated with low Apgar score, respiratory complications, and treatmentfor infection.

CONCLUSIONS: The placental ratio in pregnancies complicated by IGT was unrelated to maternal characteristics or glycemic status, but a high ratio was associated with increased perinatal morbidity.

Key Words: Pregnancy • impaired glucose tolerance • placental ratio • perinatal • morbidity

Reproductive Sciences, Vol. 8, No. 6, 347-350 (2001)
DOI: 10.1177/107155760100800607
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