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Placental location site and adverse antepartum pregnancy complications: a meta-analysis and review of the literature

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Abstract

Purpose

The purpose to the study was to determine the relationship, if any, between the placental location site and antepartum complications of pregnancy.

Methods

A University research librarian conducted a comprehensive literature search using the search engines PubMed and Web of Science. The search terms were “placental location” AND “pregnancy complications” OR “perinatal complications. There were no limits put on the years of the search.

Results

The search identified 110 articles. After reviewing all the abstracts, relevant full articles, and references of full articles, there were 22 articles identified specific to antepartum complications. Central + fundal locations compared to all lateral were associated with a lower risk of hypertension during pregnancy RR = 0.47, 95% CI: 0.31–0.71]. Central location compared to all lateral was also associated with lower risk of hypertension during pregnancy [RR = 0.39, 95% CI: 0.26–0.59]. Placenta locations in the lower uterine segment were associated with greater risk of antepartum hemorrhage (APH) [RR = 2.99, 95% CI: 1.16–7.75] compared to above the lower uterine segment. No differences were observed in placental locations and gestational diabetes (GDM), preterm prelabor rupture of membranes (PPROM), preterm delivery (PTD) or on a placental abruption.

Conclusion

Central and fundal location sites and central location alone decreased the risk of hypertension during pregnancy. Low uterine segment location sites increased the risk for APH. There were no effects of placenta location sites on the development of GDM, PPROM, PTD or abruption.

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Acknowledgements

We would like to thank Donna Eastham, BA, CRS for her assistance in manuscript editing and submission. We would also like to thank Sheila Thomas, MA(LS), MEd for her assistance with the literature search.

Funding

This research received no funding.

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Authors and Affiliations

  1. Departments of Obstetrics and Gynecology, University of Arkansas for the Medical Sciences, 4301 W. Markham, Little Rock, AR, 72205-7199, USA

    M. Luann Racher, Madison Morris, Amy P. Scott & Everett F. Magann

  2. Departments of Biostatistics, University of Arkansas for the Medical Sciences, 4301 W. Markham, Little Rock, AR, USA

    Songthip T. Ounpraseuth & Zhuopei Hu

  3. Departments of Pathology, University of Arkansas for the Medical Sciences, 4301 W. Markham, Little Rock, AR, USA

    Charles M. Quick

  4. Naval Medical Center Portsmouth, Portsmouth, VA, USA

    Julie R. Whittington

  5. Uniformed Services University of Health Sciences, Bethesda, USA

    Julie R. Whittington

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  1. M. Luann Racher
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Contributions

R: Protocol/project development, Data collection and management, Manuscript writing/editing. M: Data collection, Manuscript writing/editing. S: Data collection, Manuscript writing/editing. O: Data analysis, Manuscript writing/editing. H: Data analysis, Manuscript writing/editing. W: Protocol/project development, Data collection and management, Manuscript writing/editing. Q: Project development, Manuscript writing/editing. M: Protocol/project development, Data management, Manuscript writing/editing.

Corresponding author

Correspondence to Everett F. Magann.

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Conflict of interest

Everett F. Magann, MD is the author of an UptoDate article on Amniotic Fluid Volume Assessment: Oligohydramnios, and receives royalties for this work. All other authors report nothing to disclose.

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Julie R. Whittington is a military service member. The views expressed in this article reflect the results of research conducted by the author(s) and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the United States Government. This work was prepared as part of my official duties. Title 17 U.S.C. 105 provides that “Copyright protection under this title is not available for any work of the United States government.” Title 17 U.S.C. 101 defines a United States government work as a work prepared by a military service member or employee of the United States government as part of that person’s official duties.

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Racher, M.L., Morris, M., Scott, A.P. et al. Placental location site and adverse antepartum pregnancy complications: a meta-analysis and review of the literature. Arch Gynecol Obstet 305, 1265–1277 (2022). https://doi.org/10.1007/s00404-021-06253-x

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