Placental pathology and neurological morbidity in preterm infants during the first two weeks after birth

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: 25-31weeks, 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; BW; FTV; GA; GMs; General movements; MOS; MVU; NRBC; PPROM; Placental pathology; Preterm infants; SNAPPE; VUE; ascending intrauterine infection; birth weight; foetal thrombotic vasculopathy; general movements; gestational age; maternal vascular underperfusion; motor optimality score; nucleated red blood cells; preterm pre-labour rupture of the membranes; score of neonatal acute physiology perinatal extension; villitis placenta of unknown aetiology.