Correlation between placental histopathology and fetal/neonatal outcome: chorioamnionitis and funisitis are associated to intraventricular haemorrage and retinopathy of prematurity in preterm newborns.
BACKGROUND
Placental anatomopathologic lesions are usually associated with pregnancy complications and neonatal impaired outcome.


METHODS
We included in our study 122 patients with gestational age of 26-35 weeks. From the analysis of three pathological aspects (chorioamnionitis, funisitis and chronic hypoxia), a score was assigned to each lesion depending on the severity of the alteration, to establish a correlation with an impaired neonatal outcome in preterm newborns.


RESULTS
We found a correlation between chronic hypoxia and preeclampsia, intrauterine growth restriction and/or small-for-gestational age status at birth. Our results also showed the strong association of fetal placental inflammatory status (chorioamnionitis and funisitis) with premature rupture of membranes, very low birth weight, birth at/before 32 gestational weeks, late-onset sepsis, patent duct arteriosus, intraventricular haemorrhage (IVH) and retinopathy of prematurity (ROP).


CONCLUSIONS
We confirm that placental lesions are associated with impaired pregnancy and neonatal outcome. During pregnancy it may be useful to identify some markers of inflammatory status and chronic hypoxia for an early diagnosis and a detailed monitoring of pregnancy course. Placental pathological analysis is very important to predict the risk of developing serious complications of preterm birth as ROP and IVH.
Neonatology and Neonatal Intensive Care Unit, Department of Pediatrics, S. Chiara Hospital/University of Pisa, Italy. francescam82@gmail.com
Francesca
F
Moscuzza
Francesca
F
Belcari
Vincenzo
V
Nardini
Ambra
A
Bartoli
Chiara
C
Domenici
Armando
A
Cuttano
Paolo
P
Ghirri
Antonio
A
Boldrini
D002821:Chorioamnionitis / Q000473:pathology*; D005260:Female; D005317:Fetal Growth Retardation / Q000209:etiology; D005322:Premature Rupture of Fetal Membranes / Q000209:etiology; D005865:Gestational Age; D006801:Humans; D000860:Hypoxia / Q000150:complications*; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D019102:Infant, Very Low Birth Weight; D020300:Intracranial Hemorrhages / Q000209:etiology*; D008297:Male; D010920:Placenta / Q000473:pathology*; D011225:Pre-Eclampsia / Q000209:etiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D012178:Retinopathy of Prematurity / Q000209:etiology*; D012189:Retrospective Studies; D018805:Sepsis / Q000150:complications