Placental pathology and clinical outcomes in a cohort of infants admitted to a neonatal intensive care unit.
Placental pathology predicts persistent neurological impairment, even in normally grown infants. However, few studies have linked placental pathology with neonatal outcomes in a large population.



We matched the clinical outcomes of a cohort of neonates admitted to a neonatal intensive care unit (NICU) with placental pathology, where available, and examined (by multivariable logistic regression) the relationship between placental pathologies and these outcomes. The outcomes included neonatal death, necrotizing enterocolitis, and intraventricular hemorrhage > or = grade 3. A forward selection model (10% significance level for entry) was used after adjusting for onfounding factors.



A detailed gross and microscopic pathological report was available for 1296 eligible infants (64%). Specific placental features were associated with specific neonatal outcomes. The Canadian Neonatal Network has previously determined that specific changes in the pattern of neonatal care can alter the incidence and severity of these outcomes. In the placentas from pregnancies delivering small for gestational age infants who were subsequently admitted to NICU, two different patterns of placental pathologies were found, one ischemic and the other inflammatory.



Frozen section examination of placentas may facilitate more timely delivery of tailored neonatal therapy.
Beaudet
Luc
L
Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC.
Karuri
Stella
S
Centre for Healthcare Innovation and Improvement, Child and Family Research Institute, University of British Columbia, Vancouver BC.
Lau
Jacqueline
J
School of Medicine, Queen's University, Kingston ON.
Magee
Fergall
F
Department of Pathology and Laboratory Medicine and Department of Pediatrics, University of British Columbia, Vancouver BC.
Lee
Shoo K
SK
Centre for Healthcare Innovation and Improvement, Child and Family Research Institute, University of British Columbia, Vancouver BC; Department of Pathology and Laboratory Medicine and Department of Pediatrics, University of British Columbia, Vancouver BC; Department of Paediatrics, University of Alberta, Edmonton AB.
von Dadelszen
Peter
P
Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC; Centre for Healthcare Innovation and Improvement, Child and Family Research Institute, University of British Columbia, Vancouver BC.
D001955:British Columbia / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D007363:Intensive Care Units, Neonatal; D008297:Male; D017063:Outcome Assessment, Health Care; D010343:Patient Admission; D010920:Placenta / Q000473:pathology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies