Understanding Intrauterine Growth Restriction through Placental Histopathology: A Regional Perspective from Central India

Introduction Intrauterine Growth Restriction (IUGR) is a major obstetric complication associated with increased perinatal morbidity and mortality. The condition arises from multifactorial causes, among which placental insufficiency plays a central role. Histopathological evaluation of the placenta can offer critical insights into the underlying mechanisms of fetal growth restriction. This study aimed to analyze the correlation between placental pathology and birth weight in IUGR cases at a tertiary care center in Central India. Materials and Methods A cross-sectional observational study was conducted over 2.5 years involving 100 pregnant women with ultrasonographically diagnosed IUGR. Clinical data including maternal age, BMI, parity, socioeconomic status, and hypertensive disorders were collected. Antenatal Doppler indices such as umbilical artery pulsatility index (PI) and cerebroplacental ratio (CPR) were recorded. After delivery, placentas were grossly and histologically examined for lesions including infarction, chorangiosis, syncytial knotting, and fetal thrombotic vasculopathy. Statistical analysis was performed using Chi-square and Fishers exact tests. Results Maternal age 20 years and BMI 18.5 were significantly associated with low birth weight (p0.0001 and p0.001 respectively). Hypertensive disorders of pregnancy were present in 64 of cases and showed a strong correlation with low birth weight (p0.0001). Placental weight 450g was significantly associated with birth weight 2.5 kg. Key histopathological lesions placental infarction, chorangiosis, syncytial knotting, and fetal thrombosis were significantly more frequent in low birth weight cases (p0.05). Cumulative analysis showed that specific combinations of placental pathologies were highly predictive of adverse neonatal outcomes (p0.0001). Conclusions Placental pathology is a significant determinant of fetal growth outcomes in IUGR. Early identification of maternal risk factors and timely placental assessment can guide better clinical management and improve neonatal health.