The placenta in infants >36 weeks gestation with neonatal encephalopathy: a case control study.
OBJECTIVE
To determine placental characteristics associated with neonatal encephalopathy (NE) and correlate these with short- and long-term neurodevelopmental outcome.


METHODS
Case/control study.


METHODS
Neonatal Intensive Care Unit, Rotunda Hospital, Dublin, Ireland.


METHODS
Newborns ≥36 weeks gestation, with NE (cases). Healthy term newborns (controls).


METHODS
Placental pathology was obtained from the official placental report. Brain MRI was blindly reviewed. Children were assessed using a variety of standardised assessments. Data were analysed using multinomial logistic regression analysis.


METHODS
RRR for grade of encephalopathy. OR for neurodevelopmental outcome.


RESULTS
Placental reports were available on 141 cases (76 grade 1; 46 grade 2; 19 grade 3) and 309 control infants. Meconium phagocytosis, haemorrhage, raised placental to birth weight ratio and/or markers of infection/inflammation were independently associated with NE and showed a synergistic effect, when combined, for short- and long-term impairments.


CONCLUSIONS
Evaluation of the mechanisms leading to the placental characteristics identified may help to characterise the causal pathway of NE.
Department of Pediatrics, Rotunda Hospital, Dublin 1, Ireland. breda.hayes@childrens.harvard.edu
Breda C
BC
Hayes
Sharon
S
Cooley
Jennifer
J
Donnelly
Elaine
E
Doherty
Andrea
A
Grehan
Cathy
C
Madigan
Cliona
C
McGarvey
Siobhan
S
Mulvany
Stephanie
S
Ryan
John
J
Gillian
Michael P
MP
Geary
Tom G
TG
Matthews
Mary D
MD
King
D001927:Brain Diseases / Q000503:physiopathology*; D016022:Case-Control Studies; D002658:Developmental Disabilities / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000503:physiopathology*; D007363:Intensive Care Units, Neonatal; D007494:Ireland; D008297:Male; D010920:Placenta / Q000473:pathology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology*; D018570:Risk Assessment