Publication:

Determinants of calcified placenta and its association with fetal outcome among mothers who gave birth in Southern Ethiopia, 2018

Background Placenta is a complex multifunctional organ that maintains pregnancy and promotes normal fetal development. Fetal outcome is adversely influenced by pathological changes in placenta because it is a mirror which reflects intrauterine status of fetus. Placental abnormalities are considered as leading cause of maternal and perinatal mortality. Objective of the study was to assess determinants of calcified placenta and its association with fetal outcomes.

Methods Institutional based unmatched case-control study was conducted on 213 placentas from mothers who gave birth at Dilla university referral hospital with an age range of 19-34 years. Calcifications were assessed radiologically and graded according to Grannum. Bivariate logistic regression analysis was identified and fitted to the multiple logistic regression analysis to identify the independent effects of each variable to the outcome variable. Chi-square test was used to find the potential association between grade two and above levels of calcification and fetal outcomes.

Results Total 213 singles parturient with their placenta above 37 weeks gestational age were included. The likelihood of developing grade two and above level of calcification associated with the following variables: educational status (OR=3.134; 95%CI: 1.208, 8.135),parity (OR 3.125; 95% CI: 1.354, 7.213) ,maternal anemia (OR 6.834;95%C: I2.626,17.803), smoking (OR 6.343;95% CI: 2.624,15.334),  abruption (OR 6.046;95% CI: 2.392,15.277), and pregnancy- induced hypertension (OR 4.868 ;95% CI: 2.095,11.354). In this study, neonatal outcomes in grade II and above level of calcification were poorer than grade I and bellow level of calcification in chi-square association test.

Conclusions Grade II and above level of placental calcification (case) was significantly associated with maternal pregnancy-induced pathologies, number of parity, maternal educational status, and results in different kind of anomalies, maternal and neonatal mortality. Therefore, the practice of placental examination before and after birth guarantees for feto-maternal wellbeing.