{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:56:02Z","timestamp":1760151362130,"version":"build-2065373602"},"reference-count":28,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T00:00:00Z","timestamp":1646870400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Placental pathology is a common antecedent factor in infants born small for gestational age. Maternal region of birth can influence rates of SGA. Aims: To determine the association of maternal region of birth on placental pathology in babies that are born small, comparing a South Asian born population with Australia and New Zealand born women. Materials and methods: A retrospective cohort study was conducted at Monash Health, the largest public health service in Victoria. Mother-baby pairs above 34 weeks\u2019 gestation and birth weight less than 10th centile born in 2016 were included. Placental pathology reports and medical records were reviewed. Statistical analyses of placental and selected neonatal outcomes data were performed. Results: Three hundred and eleven small for gestational age babies were included in this study, of which 171 were born to South Asian mothers and 140 to Australian and New Zealand mothers. There were no significant differences in gestational age at birth between the groups (38.7 (1.6) vs. 38.3 (1.7) weeks, p = 0.06). Placental pathology (macroscopic and microscopic) data comparisons showed no significant differences between the two groups (81% major abnormality in both groups). This was despite South Asian small for gestational age babies being less likely to require admission to a special care nursery or neonatal intensive care unit (35 vs. 41%, p = 0.05), or have a major congenital abnormality (2.3 vs. 4.3%, p = 0.04). Conclusion: In this observational study, maternal region of birth did not have an influence on placental pathology of babies born small, despite some differences in neonatal outcomes.<\/jats:p>","DOI":"10.3390\/children9030388","type":"journal-article","created":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T11:46:47Z","timestamp":1646912807000},"page":"388","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Influence of Maternal Region of Birth on Placental Pathology of Babies Born Small"],"prefix":"10.3390","volume":"9","author":[{"given":"Mindi","family":"Fernando","sequence":"first","affiliation":[{"name":"Monash Newborn, Monash Children\u2019s Hospital, Melbourne, VIC 3168, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nalin","family":"Choudhary","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Monash University, Melbourne, VIC 3168, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beena","family":"Kumar","sequence":"additional","affiliation":[{"name":"Monash Health Pathology, Melbourne, VIC 3168, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natasha","family":"Juchkov","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Monash University, Melbourne, VIC 3168, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn","family":"Shearer","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Monash University, Melbourne, VIC 3168, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stacey J.","family":"Ellery","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Monash University, Melbourne, VIC 3168, Australia"},{"name":"The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC 3168, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miranda","family":"Davies-Tuck","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Monash University, Melbourne, VIC 3168, Australia"},{"name":"The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC 3168, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9664-4182","authenticated-orcid":false,"given":"Atul","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Monash Newborn, Monash Children\u2019s Hospital, Melbourne, VIC 3168, Australia"},{"name":"Department of Paediatrics, Monash University, Melbourne, VIC 3168, Australia"},{"name":"The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC 3168, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1016\/j.bpobgyn.2009.06.003","article-title":"Risk factors for small for gestational age infants","volume":"23","author":"McCowan","year":"2009","journal-title":"Best Pract. Res. Clin. Obstet. Gynaecol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"55","DOI":"10.3389\/fendo.2019.00055","article-title":"Neonatal Morbidities of Fetal Growth Re-striction: Pathophysiology and Impact","volume":"10","author":"Malhotra","year":"2019","journal-title":"Front. Endocrinol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12884-016-1187-2","article-title":"Maternal Asian ethnicity and obstetric intrapartum intervention: A retrospective cohort study","volume":"17","author":"Reddy","year":"2017","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.placenta.2018.04.014","article-title":"Parental ethnicity and placental maternal vascular malperfusion pathology in healthy nulliparous women","volume":"66","author":"Audette","year":"2018","journal-title":"Placenta"},{"key":"ref_5","first-page":"1719","article-title":"Analysis of perinatal risk factors for small-for-gestational-age and appropriate-for-gestational-age late-term infants","volume":"19","author":"Cheng","year":"2020","journal-title":"Exp. Ther. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1111\/apa.15375","article-title":"Influence of maternal region of birth on neonatal outcomes of babies born small","volume":"110","author":"Young","year":"2021","journal-title":"Acta Paediatr."},{"key":"ref_7","first-page":"490","article-title":"Intrauterine growth restriction","volume":"99","author":"Resnik","year":"2002","journal-title":"Obstet. Gynecol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"67","DOI":"10.4137\/CMPed.S40070","article-title":"Intrauterine Growth Restriction: Antenatal and Postnatal Aspects","volume":"10","author":"Sharma","year":"2016","journal-title":"Clin. Med. Insights Pediatr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"3453","DOI":"10.1113\/jphysiol.2009.173252","article-title":"Intrauterine growth restriction, human placental development and trophoblast cell death","volume":"587","author":"Scifres","year":"2009","journal-title":"J. Physiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1136\/jech.56.9.684","article-title":"Persistence of lower birth weight in second generation South Asian babies born in the United Kingdom","volume":"56","author":"Margetts","year":"2002","journal-title":"J. Epidemiol. Community Health"},{"key":"ref_11","unstructured":"Division UNS (2008). Composition of Macro Geographical (Continental) Regions, Geographical Sub-Regions, and Selected Economic and Other Groupings, United Nations Statistics Division (UNSD)."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"291","DOI":"10.5694\/mja11.11331","article-title":"Australian national birthweight percentiles by sex and gestational age, 1998\u20132007","volume":"197","author":"Dobbins","year":"2012","journal-title":"Med. J. Aust."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"698","DOI":"10.5858\/arpa.2015-0225-CC","article-title":"Sampling and Definitions of Placental Lesions: Amsterdam Placental Workshop Group Consensus Statement","volume":"140","author":"Khong","year":"2016","journal-title":"Arch. Pathol. Lab. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1136\/bmj.39132.482025.80","article-title":"Racial variation in the association between gestational age and perinatal mortality: Prospective study","volume":"334","author":"Balchin","year":"2007","journal-title":"BMJ"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1515\/jpm-2012-0228","article-title":"Ethnic disparities in perinatal mortality at 40 and 41 weeks of gestation","volume":"41","author":"Ravelli","year":"2013","journal-title":"J. Perinat. Med."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Davies-Tuck, M.L., Davey, M.A., and Wallace, E.M. (2017). Maternal region of birth and stillbirth in Victoria, Australia 2000\u20132011: A retro-spective cohort study of Victorian perinatal data. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0178727"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"429097","DOI":"10.4061\/2011\/429097","article-title":"Prevalence and Impact of Thyroid Disorders on Maternal Outcome in Asian-Indian Pregnant Women","volume":"2011","author":"Nambiar","year":"2011","journal-title":"J. Thyroid Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.pedneo.2013.05.005","article-title":"Parental Smoking During Pregnancy and Its Association with Low Birth Weight, Small for Gestational Age, and Preterm Birth Offspring: A Birth Cohort Study","volume":"55","author":"Ko","year":"2014","journal-title":"Pediatr. Neonatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1136\/archdischild-2018-316418","article-title":"The influence of maternal ethnicity on neonatal res-piratory outcome","volume":"105","author":"Cox","year":"2020","journal-title":"Arch. Dis. Child. Fetal Neonatal Ed."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1016\/j.annepidem.2005.10.005","article-title":"Birth Weights of Black African Babies of Migrant and Nonmigrant Mothers Compared with Those of Babies of European Mothers in Portugal","volume":"16","author":"Harding","year":"2006","journal-title":"Ann. Epidemiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"F133","DOI":"10.1136\/adc.2011.213702","article-title":"On behalf of the NSW and the ACT Neonatal Intensive Care Units (NICUs) Group The associations between ethnicity and outcomes of infants in neonatal intensive care units","volume":"97","author":"Ruan","year":"2012","journal-title":"Arch. Dis. Child. Fetal Neonatal Ed."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"37","DOI":"10.2350\/15-04-1621-OA.1","article-title":"Placental and Clinical Characteristics of Term Small-for-Gestational-Age Neonates: A Case-Control Study","volume":"19","author":"Chisholm","year":"2016","journal-title":"Pediatr. Dev. Pathol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1055\/s-2007-999316","article-title":"Placental Pathology of Idiopathic Intrauterine Growth Retardation at Term","volume":"9","author":"Salafia","year":"1992","journal-title":"Am. J. Perinatol."},{"key":"ref_24","first-page":"1755651","article-title":"Birth-weight differences at term are explained by placental dysfunction and not by maternal ethnicity. Study in newborns of first generation immigrants","volume":"2020","author":"Buongiorno","year":"2020","journal-title":"J. Matern. Neonatal Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1111\/j.1471-0528.1983.tb08911.x","article-title":"Birthweight and ethnicity","volume":"90","author":"Barron","year":"1983","journal-title":"Br. J. Obstet. Gynaecol."},{"key":"ref_26","first-page":"15042","article-title":"Racial disparity in placental pathology in the collaborative per-inatal project","volume":"8","author":"Chen","year":"2015","journal-title":"Int. J. Clin. Exp. Pathol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.placenta.2018.07.017","article-title":"Race and risk of maternal vascular malperfusion lesions in the placenta","volume":"69","author":"Parks","year":"2018","journal-title":"Placenta"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1097\/AOG.0000000000000100","article-title":"Placental Findings in Singleton Stillbirths","volume":"123","author":"Pinar","year":"2014","journal-title":"Obstet. Gynecol."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/3\/388\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:34:10Z","timestamp":1760135650000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/3\/388"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,10]]},"references-count":28,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,3]]}},"alternative-id":["children9030388"],"URL":"https:\/\/doi.org\/10.3390\/children9030388","relation":{},"ISSN":["2227-9067"],"issn-type":[{"type":"electronic","value":"2227-9067"}],"subject":[],"published":{"date-parts":[[2022,3,10]]}}}