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Placental pathology and neurological morbidity in preterm infants during the first two weeks after birth
Authors:AM Roescher  A Timmer  MM Hitzert  NKS de Vries  EA Verhagen  JJHM Erwich  AF Bos
Institution:1. Division of Neonatology, Beatrix Children''s Hospital, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands;2. Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands;3. Department of Paediatrics, Medical Centre Leeuwarden, Leeuwarden, The Netherlands;4. Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Abstract:

Background

The placenta plays a crucial role during pregnancy and dysfunction causes long-term neurological problems. Identifying placenta-related risks for neurological problems shortly after birth may provide clues for early interventions aiming to improve neurological outcome.

Objective

To determine the association between placental pathology and neurological morbidity in preterm infants during the first two weeks after birth.

Study design

Placentas of 52 singleton, preterm infants (GA: 25–31 weeks, BW: 560–2250 grammes) were examined for histopathology. The infants' neurological condition shortly after birth was determined by assessing the quality of their general movements (GMs): normal, abnormal, or hypokinetic, on days 5, 8, and 15. A motor optimality score (MOS) was also assigned.

Results

Examination of the placentas revealed maternal vascular underperfusion (n = 29), ascending intrauterine infection (AIUI) (n = 19), villitis of unknown aetiology (n = 6), chronic deciduitis (n = 11), foetal thrombotic vasculopathy (FTV) (n = 9), and elevated nucleated red blood cells (NRBCs) as a marker for foetal hypoxia (n = 7). None of the placental lesions were significantly associated with the quality of GMs or MOS.

Conclusions

This study indicated that placental lesions were not associated with infants' neurological condition as measured by the quality of their general movements during the first two weeks after birth.
Keywords:AIUI  ascending intrauterine infection  BW  birth weight  FTV  foetal thrombotic vasculopathy  GA  gestational age  GMs  general movements  NRBC  nucleated red blood cells  MVU  maternal vascular underperfusion  MOS  motor optimality score  PPROM  preterm pre-labour rupture of the membranes  SNAPPE  score of neonatal acute physiology perinatal extension  VUE  villitis placenta of unknown aetiology
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