Placental pathology is associated with illness severity in preterm infants in the first twenty-four hours after birth.

Abstract:

BACKGROUND:Placental pathology is associated with long-term neurological morbidity. Little is known about the association of placental pathology and illness severity directly after birth in preterm infants. OBJECTIVE:To determine the association between placental pathology and illness severity in preterm infants during the first 24 h after birth. STUDY DESIGN:Placentas of 40 preterm infants, born after singleton pregnancies (gestational age 25.4-31.7 weeks, birth weight 560-2250 g) were assessed for histopathology. Illness severity was measured using the Score of Neonatal Acute Physiology Perinatal Extension (SNAPPE). A high SNAPPE reflects high illness severity. RESULTS:Examination of the 40 placentas revealed: pathology consistent with maternal vascular underperfusion (MVU) (n=24), ascending intrauterine infection (AIUI) (n=17), villitis of unknown aetiology (VUE) (n=6), foetal thrombotic vasculopathy (FTV) (n=6), elevated nucleated red blood cells (NRBCs) (n=6), and chronic deciduitis (n=10). SNAPPE ranged from 1 to 53 (median 10). Infants with elevated NRBCs had a higher SNAPPE than infants without elevated NRBCs (median 30 vs. 10, p=0.014). The same was found for the presence of FTV (median 30 vs. 10, p=0.019). No relation existed between SNAPPE and the other placental pathologies. CONCLUSIONS:Elevated NRBCs and FTV were associated with higher illness severity during the first 24 h after birth in preterm infants. Ascending intrauterine infection was not associated with high illness severity.

journal_name

Early Hum Dev

journal_title

Early human development

authors

Roescher AM,Hitzert MM,Timmer A,Verhagen EA,Erwich JJ,Bos AF

doi

10.1016/j.earlhumdev.2011.01.040

subject

Has Abstract

pub_date

2011-04-01 00:00:00

pages

315-9

issue

4

eissn

0378-3782

issn

1872-6232

pii

S0378-3782(11)00077-6

journal_volume

87

pub_type

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