Ischemic placental disease and risks of perinatal mortality and morbidity and neurodevelopmental outcomes.
Preeclampsia, intrauterine growth restriction, and placental abruption are serious obstetrical complications that constitute the syndrome of ischemic placental disease and account for a disproportionate degree of perinatal morbidity and mortality. We review the risks of stillbirth and neonatal and infant mortality in relation to ischemic placental disease, focusing on population-based studies. We also review the risks of neonatal morbidity and neurodevelopmental outcomes in relation to ischemic placental disease. A synthesis of the findings of the relevant studies relating ischemic placental disease to adverse perinatal outcomes underscores two important observations. First, despite the low prevalence of each of the three obstetrical complications, all are associated with increased risks of adverse perinatal and infant outcomes, as well as neurodevelopmental deficits. Second, the burden of increased perinatal risks appears strongest during the preterm period. Efforts to reduce the risks of ischemic placental disease remain critically important and developing effective clinical interventions will be a target worthy for consideration.
Department of Obstetrics and Gynecology, College of Physicians and Surgeons, Columbia University, New York, NY; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY. Electronic address: cande.ananth@columbia.edu.
Cande V
CV
Ananth
Department of Obstetrics and Gynecology, College of Physicians and Surgeons, Columbia University, New York, NY.
Alexander M
AM
Friedman
D000037:Abruptio Placentae / Q000401:mortality*; D002657:Child Development; D005260:Female; D005317:Fetal Growth Retardation / Q000209:etiology / Q000401:mortality*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007511:Ischemia / Q000150:complications*; D019636:Neurodegenerative Diseases / Q000209:etiology / Q000401:mortality*; D054238:Perinatal Mortality; D010920:Placenta / Q000098:blood supply*; D010922:Placenta Diseases / Q000401:mortality* / Q000517:prevention & control; D011225:Pre-Eclampsia / Q000209:etiology / Q000401:mortality*; D011247:Pregnancy; D011256:Pregnancy Outcome; D015995:Prevalence; D012307:Risk Factors; D050497:Stillbirth / Q000453:epidemiology*
Intrauterine growth restriction; Ischemic placental disease; Neurodevelopmental outcomes; Perinatal mortality; Placental abruption; Preeclampsia; Stillbirth