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. 2013 May;98(3):F233-9.
doi: 10.1136/archdischild-2012-301992. Epub 2012 Jul 12.

The placenta in infants >36 weeks gestation with neonatal encephalopathy: a case control study

Breda C Hayes  1 , Sharon Cooley, Jennifer Donnelly, Elaine Doherty, Andrea Grehan, Cathy Madigan, Cliona McGarvey, Siobhan Mulvany, Stephanie Ryan, John Gillian, Michael P Geary, Tom G Matthews, Mary D King
Affiliations

The placenta in infants >36 weeks gestation with neonatal encephalopathy: a case control study

Breda C Hayes et al. Arch Dis Child Fetal Neonatal Ed. 2013 May.

Abstract

Objective: To determine placental characteristics associated with neonatal encephalopathy (NE) and correlate these with short- and long-term neurodevelopmental outcome.

Design: Case/control study.

Setting: Neonatal Intensive Care Unit, Rotunda Hospital, Dublin, Ireland.

Patients: Newborns ≥36 weeks gestation, with NE (cases). Healthy term newborns (controls).

Interventions: Placental pathology was obtained from the official placental report. Brain MRI was blindly reviewed. Children were assessed using a variety of standardised assessments. Data were analysed using multinomial logistic regression analysis.

Main outcome measures: RRR for grade of encephalopathy. OR for neurodevelopmental outcome.

Results: Placental reports were available on 141 cases (76 grade 1; 46 grade 2; 19 grade 3) and 309 control infants. Meconium phagocytosis, haemorrhage, raised placental to birth weight ratio and/or markers of infection/inflammation were independently associated with NE and showed a synergistic effect, when combined, for short- and long-term impairments.

Conclusions: Evaluation of the mechanisms leading to the placental characteristics identified may help to characterise the causal pathway of NE.

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