ArticlePaediatric and perinatal epidemiology2019
The association of stillbirth with placental abnormalities in growth-restricted and normally grown fetuses.
Article in Paediatric and perinatal epidemiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
8 citing papers in PubMed, 14 citations in OpenAlex.
- Review
- Stillbirth in Iceland 1996-2021: Incidence and etiology.Acta obstetricia et gynecologica Scandinavica · 2025Article
- The human placenta and its role in reproductive outcomes revisited.Physiological reviews · 2025Review
- A Narrative Review on the Effect of Valproic Acid on the Placenta.Birth defects research · 2025Review
- Assessment of the development of the central nervous system in fetuses with fetal growth restriction.Archives of gynecology and obstetrics · 2024Article
- Placental Pathology Findings in Unexplained Pregnancy Losses.Reproductive sciences (Thousand Oaks, Calif.) · 2024Article
- Identification of the optimal growth chart and threshold for the prediction of antepartum stillbirth.Archives of gynecology and obstetrics · 2021Article
- Formulating a Meaningful and Comprehensive Placental Phenotypic Classification.Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology SocietyArticle
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8 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundStillbirth, defined as foetal death ≥20 weeks' gestation, is associated with poor foetal growth and is often attributed to placental abnormalities, which are also associated with poor foetal growth. Evaluating inter-relationships between placental abnormalities, poor foetal growth, and stillbirth may improve our understanding of the underlying mechanisms for some causes of stillbirth.
objectiveOur primary objective was to determine whether poor foetal growth, operationalised as small for gestational age (SGA), mediates the relationship between placental abnormalities and stillbirth.
methodsWe used data from the Stillbirth Collaborative Research Network study, a population-based case-control study conducted from 2006-2008. Our analysis included 266 stillbirths and 1135 livebirths. We evaluated associations of stillbirth with five types of placental characteristics (developmental disorders, maternal and foetal inflammatory responses, and maternal and foetal circulatory disorders) and examined mediation of these relationships by SGA. We also assessed exposure-mediator interaction. Models were adjusted for maternal age, race/ethnicity, education, body mass index, parity, and smoking status.
resultsAll five placental abnormalities were more prevalent in cases than controls. After adjustment for potential confounders, maternal inflammatory response (odds ratio [OR] 2.58, 95% confidence interval [CI] 1.77, 3.75), maternal circulatory disorders OR 4.14, 95% CI 2.93, 5.84, and foetal circulatory disorders OR 4.58, 95% CI 3.11, 6.74 were strongly associated with stillbirth, and the relationships did not appear to be mediated by SGA status. Associations for developmental disorders and foetal inflammatory response diverged for SGA and non-SGA births, and strong associations were only observed when SGA was not present.
conclusionsFoetal growth did not mediate the relationships between placental abnormalities and stillbirth. The relationships of stillbirth with maternal and foetal circulatory disorders and maternal inflammatory response appear to be independent of poor foetal growth, while developmental disorders and foetal inflammatory response likely interact with foetal growth to affect stillbirth risk.
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