The predictive potential of the placental chorioangioma diameter for adverse pregnancy outcomes: a single-centre retrospective study

Placental chorioangioma (PCA) is a rare placental tumour that may significantly compromise pregnancy outcomes. However, the optimal diameter cutoff value for predicting adverse outcomes remains controversial, warranting further investigation. This retrospective study enrolled 94 pregnant women diagnosed with PCA at Wenzhou Central Hospital between January 2013 and July 2025. Additionally, stratified random sampling was used to select 159 pregnant women without a placental tumour during the same period as the non-PCA group. The basic information and pregnancy outcomes of the two groups were compared. Groups with adverse pregnancy outcomes (n = 57) and those without adverse pregnancy outcomes (n = 37) were further defined. The risk variables for adverse pregnancy outcomes in PCA patients were investigated using univariate and multivariate logistic regression analyses. The therapeutic utility of the PCA diameter in evaluating adverse pregnancy outcomes in PCA patients was examined using receiver operating characteristic (ROC) curves. After stratifying the diameter, the incidence rates of adverse outcomes in different diameter intervals were statistically analysed. Multivariate logistic regression revealed that the PCA diameter was a significant, though modest, independent risk factor for adverse pregnancy outcomes (OR = 1.026, 95% CI: 1.003–1.051, P = 0.027), implying a 2.6% increase in risk per 1-mm increase in diameter. ROC analysis demonstrated that a PCA diameter cutoff of 4.7 cm predicted adverse outcomes (82.1% sensitivity, 50.0% specificity), with an AUC of 0.705 (95% CI: 0.600-0.811, P = 0.002). Abortion, mirror syndrome, foetal hydrops, foetal heart failure, foetal anaemia, intrauterine foetal death, and neonatal death mainly occurred with a PCA diameter > 9 cm. This study identifies a PCA diameter cutoff of 4.7 cm as a useful clinical tool for risk stratification. Pregnant women with a PCA diameter > 4.7 cm face higher risks of adverse outcomes, prompting recommendations for ultrasound evaluations every 1–2 weeks. These assessments should include tumour dimensions, amniotic fluid index, umbilical artery, foetal middle cerebral artery, foetal ductus venosus, and foetal echocardiography to detect complications early. A PCA diameter exceeding 9 cm significantly increases the risk of serious complications, necessitating close monitoring or taking treatment measures.