What factors influence whether placentas are submitted for pathologic examination?

OBJECTIVE: Our purpose was to investigate factors associated with submission of placentas for pathologic examination. STUDY DESIGN: In a population-based study of the etiology of cerebral palsy, data were abstracted for 627 singleton survivors to age 3 years. Children included as cases had moderate-to-severe cerebral palsy; controls were randomly selected infants born in the same counties and years. RESULTS: Placentas were submitted for pathologic examination for 150 children (24%) of those included in this study. Placentas were more often submitted for children born weighing <1500 gm than for other birth weight groups (p < 0.0001). Placentas from cesarean section deliveries were submitted more often than those from vaginal deliveries (p < 0.0001), elective repeat as often as indicated or emergency cesarean sections. Maternal and neonatal disorders suggested by the College of American Pathologists as indications for placental examination were present in 161 (43%) of controls born weighing greater than or equal to 2500 gm. These indications were not associated with pathologic submissions. CONCLUSIONS: Within birth weight groups the main determinant of placental submission for laboratory examination was surgical delivery, whether indicated or elective. Maternal and infant conditions had little influence on the likelihood of submission.