Placental pathology in relation to stillbirth and neonatal outcome in an extremely preterm population: a prospective cohort study

• Objective: To study associations between placental histopathology and stillbirth as well as neonatal outcome in a population born extremely preterm.Design: Prospective cohort study.Setting: Stockholm, Sweden.Population: 167 infants born <27 gestational weeks during 2004–2007.Methods: One senior perinatal pathologist, blinded to outcome data, evaluated all placental slides.Main outcome measures: Intrauterine fetal death, small-for-gestational age, major neonatal morbidity (intraventricular hemorrhage ≥grade 3, retinopathy of prematurity ≥grade 3, necrotizing enterocolitis, cystic periventricular leukomalacia or severe bronchopulmonary dysplasia) and neonatal mortality. Additional outcome variables were Apgar score at 5 min, sepsis, and treated patent ductus arteriosus.Results: Accelerated villous maturation was associated with a decreased risk for Apgar score <7 at 5 min (p = 0.041). Fetal thrombosis and low placental weight were associated with an increased risk for both intrauterine fetal death (p < 0.001 and p = 0.011, respectively) and small-for-gestational age (p < 0.001 and p < 0.001, respectively).Conclusion: Placental histology may have prognostic value as it appears to be associated with intrauterine fetal death, as well as with being small-for-gestational age and assignment of a low Apgar score at birth.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)

Nyckelord

Histopathology

thrombosis

placental weight

villous maturation

prematurity

Publikations- och innehållstyp

ref (ämneskategori)

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