Hematologic effects of placental pathology on very low birthweight infants born to mothers with preeclampsia.
OBJECTIVE
To investigate the effect of placental pathology on neonatal neutrophils, platelets, hematocrit and nucleated red blood cells in very low birthweight (VLBW) infants born to mothers with preeclampsia.


METHODS
Retrospective cohort study of infants with birthweight < 1500 g born to mothers with preeclampsia from july, 2002 to july, 2006 at a single level III neonatal intensive care unit. Placental pathology was reviewed for the presence of placental infarction and vasculopathy. Hematologic parameters from day of life 0, 1 and 2 were obtained. Statistical analysis included repeated-measures analysis of variance and multivariable analysis using logistic regression.


RESULTS
The study sample included 203 infants with estimated gestational age of 28+/-3 weeks; 45% had placental infarctions and 26% placental vasculopathy. Infants with neutropenia and thrombocytopenia did not have an increased occurrence of placental infarction or maternal vasculopathy but were more likely to be of small gestational age (SGA) and of lower gestational age compared with infants without neutropenia or thrombocytopenia. After multivariable analysis, gestational age and SGA remained associated with both neutropenia and thrombocytopenia whereas placental infarction and vasculopathy did not remain in the models.


CONCLUSIONS
In our population of VLBW infants born to mothers with preeclampsia, placental pathology was common. There was no association of placental infarction or vasculopathy with neonatal neutropenia and thrombocytopenia. The data suggest that neonatal hematologic effects of maternal preeclampsia, if related to the placenta, are associated with factors other than placental histology.
Zook
K J
KJ
Department of Pediatrics, Section of Neonatology, Christiana Care Health System, Newark, DE 19718, USA. Kelly.zook@mail.tju.edu
Mackley
A B
AB
Kern
J
J
Paul
D A
DA
D001792:Blood Platelets; D004912:Erythrocytes; D005260:Female; D005865:Gestational Age; D006400:Hematocrit; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000097:blood*; D007958:Leukocyte Count; D008297:Male; D009504:Neutrophils; D010920:Placenta / Q000473:pathology*; D010976:Platelet Count; D011225:Pre-Eclampsia; D011247:Pregnancy; D012189:Retrospective Studies