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

A. M. Roescher*, M. M. Hitzert, A. Timmer, E. A. Verhagen, J. J. H. M. Erwich, A. F. Bos

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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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 under-perfusion (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). SNAKE 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. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)315-319
Number of pages5
JournalEarly Human Development
Volume87
Issue number4
DOIs
Publication statusPublished - Apr-2011

Keywords

  • Placental pathology
  • Illness severity
  • SNAPPE
  • Preterm infants
  • UMBILICAL COILING INDEX
  • REACTION PATTERNS
  • CEREBRAL-PALSY
  • NEUROLOGIC IMPAIRMENT
  • TERM INFANTS
  • LESIONS
  • REPRODUCIBILITY
  • NOSOLOGY
  • PREDICTORS
  • MORTALITY

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