Placental Weight, Maternal Characteristics, and Perinatal Outcomes Are Associated with Foetal Biometric Indicators in a tertiary Care Setting

Foetal biometric indices—including birth weight, length, and head circumference—are vital markers of intrauterine development and perinatal outcomes. Although placental weight and maternal factors such as body mass index (BMI) are known to influence foetal growth, region-specific data from Middle Eastern populations remain limited. This retrospective cross-sectional study examined 335 singleton caesarean deliveries at a tertiary hospital in Najran, Saudi Arabia, between 2018 and 2020. Using delivery and neonatal records, we evaluated associations between maternal BMI, placental weight, and foetal biometric measures through descriptive statistics, Pearson correlations, and multivariable linear regression. Placental weight emerged as the strongest independent predictor of birth weight (r = 0.62, p < 0.001; β = 0.52, p < 0.001), while maternal BMI demonstrated a modest but statistically significant contribution (β = 0.18, p = 0.027). Male neonates exhibited consistently higher biometric values compared to females. An exploratory tri-variable visualization revealed compensatory growth patterns wherein increased maternal BMI partially offset the impact of lower placental mass, highlighting nuanced interactions among maternal-foetal parameters. The findings underscore the value of integrating placental and maternal metrics into routine clinical assessments to enhance personalised monitoring and perinatal risk stratification. Incorporating these predictors could refine surveillance protocols and promote targeted interventions, particularly in caesarean-delivered populations. Further region-specific research is warranted to validate these associations and support data-driven maternal-fetal health improvements across diverse clinical settings.