Abstract
The aim of this study was to evaluate the effect of parity (primipara vs multipara) on the histopathology of the placenta in singleton live births following in vitro fertilization. We conducted a retrospective cohort study evaluating data of all IVF resulted live births from one university affiliated hospital during 2009–2017. All patients had the placenta sent for pathological evaluation. Exclusion criteria were history of miscarriage or elective termination of pregnancy, abnormal uterine cavity findings, previous uterine surgery, in vitro maturation cycles, gestational carrier cycles, oocyte recipient cycles, preimplantation genetic diagnosis cycles, and multiple pregnancies. The outcomes measured included anatomical, inflammation, vascular malperfusion, and villous maturation placental features. A multivariate analysis was conducted to adjust the results for factors potentially associated with placental pathology features. A total of 395 live births were included in the final analysis and were allocated to the study groups according to parity: primipara (n = 273) and multipara (n = 122). After adjustment for potential confounding factors, multiparity was found to be significantly associated with delayed villous maturation (OR 4.9; 95% CI 1.2–19.8) and primiparity was significantly associated with maternal vascular malperfusion (OR 0.6; 95% CI 0.3–0.8). We showed that parity has an impact on placental histopathological changes which in turn may affect perinatal outcome.
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References
Maeda Y, Kaneko K, Ogawa K, Sago H, Murashima A. The effect of parity, history of preeclampsia, and pregnancy care on the incidence of subsequent preeclampsia in multiparous women with SLE. Mod Rheumatol. 2021;31:843–8.
Lin L, Lu C, Chen W, Li C, Guo VY. Parity and the risks of adverse birth outcomes: a retrospective study among Chinese. BMC Pregnancy Childbirth. 2021;21(1):257.
Luo ZC, An N, Xu HR, Larante A, Audibert F, Fraser WD. The effects and mechanisms of primiparity on the risk of pre-eclampsia: a systematic review. Paediatr Perinat Epidemiol. 2007;21(Suppl 1):36–45.
Prefumo F, Bhide A, Sairam S, Penna L, Hollis B, Thilaganathan B. Effect of parity on second-trimester uterine artery Doppler flow velocity and waveforms. Ultrasound Obstet Gynecol. 2004;23(1):46–9.
Suzuki S. Influence of parity on second-trimester uterine artery Doppler waveforms in twin pregnancy. J Matern Fetal Neonatal Med. 2006;19(3):193–4.
Edmondson N, Bocking A, Machin G, Rizek R, Watson C, Keating S. The prevalence of chronic deciduitis in cases of preterm labor without clinical chorioamnionitis. Pediatr Dev Pathol. 2009;12(1):16–21.
Kim CJ, Romero R, Kusanovic JP, Yoo W, Dong Z, Topping V, Gotsch F, Yoon BH, Chi JG, Kim JS. The frequency, clinical significance, and pathological features of chronic chorioamnionitis: a lesion associated with spontaneous preterm birth. Mod Pathol. 2010;23(7):1000–11.
Jaiman S, Romero R, Pacora P, Jung EJ, Kacerovsky M, Bhatti G, Yeo L, Hsu CD. Placental delayed villous maturation is associated with evidence of chronic fetal hypoxia. J Perinat Med. 2020;48(5):516–8.
Higgins M, McAuliffe FM, Mooney EE. Clinical associations with a placental diagnosis of delayed villous maturation: a retrospective study. Pediatr Dev Pathol. 2011;14(4):273–9.
Volodarsky-Perel A, Nu TNT, Buckett W, Machado-Gedeon A, Cui Y, Shaul J, Dahan MH. Effect of embryo stage at transfer on placental histopathology features in singleton live births resulting from fresh embryo transfers. Fertil Steril. 2021;115(3):673–82.
Volodarsky-Perel A, Nu TNT, Tulandi T, Buckett W, Gil Y, Machado-Gedeon A, Cui Y, Shaul J, Dahan MH. Impact of intramural non-cavity-distorting leiomyoma on placental histopathology and perinatal outcome in singleton live births resulting from in vitro fertilization treatment. J Assist Reprod Genet. 2020;37(8):1963–74.
Volodarsky-Perel A, Nu TNT, Buckett W, Machado-Gedeon A, Cui Y, Shaul J, Dahan MH. Effect of newborn gender on placental histopathology and perinatal outcome in singleton live births following IVF. Reprod Biomed Online. 2020;41(5):907–16.
Mizrachi Y, Weissman A, Fater GB, Torem M, Horowitz E, Schreiber L, Raziel A, Bar J, Kovo M. Placental histopathology in IVF pregnancies resulting from the transfer of frozen-thawed embryos compared with fresh embryos. J Assist Reprod Genet. 2020;37(5):1155–62.
Sacha CR, Harris AL, James K, Basnet K, Freret TS, Yeh J, Kaimal A, Souter I, Roberts DJ. Placental pathology in live births conceived with in vitro fertilization after fresh and frozen embryo transfer. Am J Obstet Gynecol. 2020;222(4):360.e1-16.
Herman HG, Mizrachi Y, Farhadian Y, Alon AS, Gluck O, Bar J, Kovo M, Raziel A. Placental disorders of pregnancy in subsequent IVF pregnancies – a sibling cohort. Reprod Biomed Online. 2021;42(3):620–6.
Khong TY, Mooney EE, Ariel I, Balmus NC, Boyd TK, Brundler MA, Derricott H, Evans MJ, Faye-Petersen OM, Gillan JE, et al. Sampling and definitions of placental lesions: Amsterdam Placental Workshop Group consensus statement. Arch Pathol Lab Med. 2016;140:698–713.
Gibbins KJ, Silver RM, Pinar H, Reddy UM, Parker CB, Thorsten V, Willinger M, Dudley DJ, Bukowski R, Saade GR, et al. Stillbirth, hypertensive disorders of pregnancy, and placental pathology. Placenta. 2016;43:61–8.
Morgan TK, Tolosa JE, Mele L, Wapner RJ, Spong CY, Sorokin Y, Dudley DJ, Peaceman AM, Mercer BM, Thorp JM, et al. Placental villous hypermaturation is associated with idiopathic preterm birth. J Matern Fetal Neonatal Med. 2013;26(7):647–53.
Burton GJ, Woods AW, Jauniaux E, Kingdom JC. Rheological and physiological consequences of conversion of the maternal spiral arteries for uteroplacental blood flow during human pregnancy. Placenta. 2009;30(6):473–82.
Guedes-Martins L, Gaio R, Saraiva J, Cerdeira S, Matos L, Silva E, Macedo F, Almeida H. Reference ranges for uterine artery pulsatility index during the menstrual cycle: a cross-sectional study. PLoS ONE. 2015;10(3): e0119103.
Derwig I, Lythgoe DJ, Barker GJ, Poon L, Gowland P, Yeung R, Zelaya F, Nicolaides K. Association of placental perfusion, as assessed by magnetic resonance imaging and uterine artery Doppler ultrasound, and its relationship to pregnancy outcome. Placenta. 2013;34(10):885–91.
Cooley SM, Donnelly JC, Walsh T, Kirkham C, Gillan J, Geary MP. Ponderal index (PI) vs birth weight centiles in the low-risk primigravid population: which is the better predictor of fetal wellbeing? J Obstet Gynaecol. 2012;32(5):439–43.
Stallmach T, Hebisch G, Meier K, Dudenhausen JW, Vogel M. Rescue by birth: defective placental maturation and late fetal mortality. Obstet Gynecol. 2001;97(4):505–9.
Khong TYME, Mooney EE, Nikkels PGJ, Morgan TK, Gordijn SJ. Pathology of the placenta: a practical guide. 1st ed. Switzerland: Springer Nature; 2019.
Higgins MF, Russell NM, Mooney EE, McAuliffe FM. Clinical and ultrasound features of placental maturation in pre-gestational diabetic pregnancy. Early Hum Dev. 2012;88(10):817–21.
Treacy A, Higgins M, Kearney JM, McAuliffe F, Mooney EE. Delayed villous maturation of the placenta: quantitative assessment in different cohorts. Pediatr Dev Pathol. 2013;16:63–6.
Kavalar R, Arko D, Fokter Dovnik N, Takač I. Subinvolution of placental bed vessels: case report and review of the literature. Wien Klin Wochenschr. 2012;124(19–20):725–30.
Stanek J. Comparison of placental pathology in preterm, late-preterm, near-term, and term births. Am J Obstet Gynecol. 2014;210(3):234.e1-6.
Esh-Broder E, Ariel I, Abas-Bashir N, Bdolah Y, Hochner CD. Placenta accreta is associated with IVF pregnancies: a retrospective chart review. BJOG. 2011;118:1084–9.
Redline RW. Classification of placental lesions. Am J Obstet Gynecol. 2015;213:S21–8.
Feist H, Brüschke C, Lehmann U, Blöcker T, Gbur K, Peters J, Müller AM. Discordancy for a villous maturation defect in a dizygotic twin placenta. Fetal Pediatr Pathol. 2019;38(5):432–6.
Machin G. Placentation in multiple births. Twin Res. 2001;4(3):150–5.
Aviram A, Giltvedt K, Sherman C, Kingdom J, Zaltz A, Barrett J, Melamed N. The role of placental malperfusion in the pathogenesis of preeclampsia in dichorionic twin and singleton pregnancies. Placenta. 2018;70:41–9.
Acknowledgements
The authors wish to thank the team members of the McGill University Reproductive Centre and Labour and Delivery. We wish to extend particular thanks to Nancy Lamothe for managing the patient database.
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Burke, Y.Z., Dahan, M.H., Nu, T.N.T. et al. Effect of Parity on Placental Histopathology Features in Singleton Live Births Following IVF. Reprod. Sci. 30, 2275–2282 (2023). https://doi.org/10.1007/s43032-023-01179-y
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DOI: https://doi.org/10.1007/s43032-023-01179-y