title: Placental pathology, perinatal death, neonatal outcome, and neurological development: a systematic review.
abstract: BACKGROUND
  The placenta plays a crucial role during pregnancy for growth and development of the fetus. Less than optimal placental performance may result in morbidity or even mortality of both mother and fetus. Awareness among pediatricians, however, of the benefit of placental findings for neonatal care, is limited.
  
  
  OBJECTIVE
  To provide a systematic overview of the relation between placental lesions and neonatal outcome.
  
  
  METHODS
  Pubmed database, reference lists of selected publications and important research groups in the field.
  
  
  METHODS
  We systematically searched the Pubmed database for literature on the relation between placental lesions and fetal and neonatal mortality, neonatal morbidity and neurological outcome. We conducted three separate searches starting with a search for placental pathology and fetal and neonatal mortality, followed by placental pathology and neonatal morbidity, and finally placental pathology and neurological development. We limited our search to full-text articles published in English from January 1995 to October 2013. We refined our search results by selecting the appropriate articles from the ones found during the initial searches. The first selection was based on the title, the second on the abstract, and the third on the full article. The quality of the selected articles was determined by using the Newcastle-Ottawa Quality Assessment Scale.
  
  
  RESULTS
  Placental lesions are one of the main causes of fetal death, where placental lesions consistent with maternal vascular underperfusion are most important. Several neonatal problems are also associated with placental lesions, whereby ascending intrauterine infection (with a fetal component) and fetal thrombotic vasculopathy constitute the greatest problem.
  
  
  CONCLUSIONS
  The placenta plays a key role in fetal and neonatal mortality, morbidity, and outcome. Pediatricians should make an effort to obtain the results of placental examinations.
authors.affiliation: Division of Neonatology, Beatrix Children's Hospital, University of Groningen, University Medical Center, Groningen, the Netherlands.
authors.forename: Annemiek M
authors.initials: AM
authors.lastname: Roescher
authors.affiliation: Department of Pathology and Medical Biology, University of Groningen, University Medical Center, Groningen, the Netherlands.
authors.forename: Albert
authors.initials: A
authors.lastname: Timmer
authors.affiliation: Department of Obstetrics and Gynecology, University of Groningen, University Medical Center, Groningen, the Netherlands.
authors.forename: Jan Jaap H M
authors.initials: JJ
authors.lastname: Erwich
authors.affiliation: Division of Neonatology, Beatrix Children's Hospital, University of Groningen, University Medical Center, Groningen, the Netherlands.
authors.forename: Arend F
authors.initials: AF
authors.lastname: Bos
mesh_terms: D016022:Case-Control Studies; D005260:Female; D005333:Fetus / Q000473:pathology*; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D007235:Infant, Premature, Diseases / Q000473:pathology*; D009422:Nervous System Diseases / Q000473:pathology*; D066087:Perinatal Death; D010920:Placenta / Q000473:pathology*; D010922:Placenta Diseases / Q000473:pathology*; D011247:Pregnancy; D011446:Prospective Studies; D012189:Retrospective Studies