Association Between Lateral Placenta and Adverse Maternal and Perinatal Outcomes: A Systematic Review and Meta-Analysis.
Joseph Arkorful, Juliana Nyamson, Theophilus Adu-Bredu et al.
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In 30 seconds
This systematic review and random-effects meta-analysis examined associations between lateral placentation and maternal and perinatal outcomes in singleton pregnancies. Across 21 studies including 162 727 pregnancies, lateral placenta was associated with higher odds of preeclampsia, SGA, preterm birth, retained placenta and non-vertex presentation. The pooled odds ratio for preeclampsia was 1.65 (95% CI: 1.25, 2.19); for preterm birth < 34 weeks it was 2.10 (95% CI: 1.62, 2.72). Adjusted analyses also found increased odds of SGA, preterm birth and retained placenta, although the authors note that further adjusted studies are needed.
Key findings
- Lateral placenta was associated with preeclampsia (OR = 1.65, 95% CI: 1.25, 2.19).
- The association with preterm birth < 34 weeks was OR = 2.10 (95% CI: 1.62, 2.72).
- Adjusted odds were higher for SGA (aOR = 1.84, 95% CI: 1.33, 2.53) and retained placenta (aOR = 4.43, 95% CI: 1.70, 11.53).
- Lateral placenta was associated with non-vertex foetal presentation at birth (OR = 1.50, 95% CI: 1.19, 1.89).
Why it matters
The findings suggest that placental location may be associated with several clinically important pregnancy outcomes, including hypertensive disease, impaired fetal growth, preterm birth and retained placenta. Recognising these associations can inform understanding of risk patterns, while the observational evidence and need for further confounder-adjusted studies mean the results should not be interpreted as proof that lateral placentation causes these outcomes.
What to keep in mind
The evidence is based on included studies with varying heterogeneity, and the authors report that more studies adjusting for confounders are needed to clarify independent associations.