بررسي يافته هاي جفتي و عوامل خطر همراه مادران در نوزادان كم وزن تازه متولدشده در زايشگاه كوثر - بيمارستان شهيد مطهري

PLACENTAL FINDINGES & MATERNAL RISK FACTOR IN LOW BIRTH WEIGHT NEONATES IN KOSAR - MOTAHARI HOSPITAL

Background : The aim of this study was placental findings & maternal risk factors of low birth weight infants and correlations of this factors with low birth weight. Methods & Materials : This study was based on randomized selection of 100 low birth weight neonates with birth weight 1000-2500 gr (case group) and 100 neonates with birth weight equale or more than 2600gr (control group) through 6 months. Informations about maternal past history and health state obtained from medical charts and physical exmination. The TSH titer of maternal serum determined for 110 patients and pathologic examination was done on placenta of all cases (200 neonates). Results : Mean maternal age was 24.48 ± 6.05 in case group and 25.80 ± 5.94 in control group. In the case group 16% of mothers were less than 18 years old and 10% in control group. Hypertension identified in 23% of case group (3% in control group). OR =9.65(95% C1:3.31-26.84), history of previous low birth weight, abortion and IUFD (intra uterine fetal death), identified in 22% of case group (20% in control group) OR=1.12(95% CI: 0.58-2.21). One or more pathological findings were present in 92% of LBW neonates and 74% in control group OR-4/04 (95% CL 1.79- 9.577). The common placental findings in case group were abnormal insertion of umbilical cords 56% (OR=1.17), increased syncytial knots more than 3 (55%) (OR =6.4) necrosis more than 10%, 16% (OR=4.5) and fibrin deposition more than 30% around the villouses 14% (OR= 7.79). Discussion: In our study maternal hypertension increased the risk of low birth weight delivery 9.65 fold above baseline. Our data suggest that gross and microscopic placental findings are significantly associated with the risk of LBW (4.04 fold) and If there was maternal hypertension, the risk of pathologic findings in placenta would be 100% .