title: Placental pathology in relation to stillbirth and neonatal outcome in an extremely preterm population: a prospective cohort study.
abstract: OBJECTIVE
  To study associations between placental histopathology and stillbirth as well as neonatal outcome in a population born extremely preterm.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Stockholm, Sweden.
  
  
  METHODS
  167 infants born <27 gestational weeks during 2004-2007.
  
  
  METHODS
  One senior perinatal pathologist, blinded to outcome data, evaluated all placental slides.
  
  
  METHODS
  Intrauterine fetal death, small-for-gestational age, major neonatal morbidity (intraventricular hemorrhage ≥grade 3, retinopathy of prematurity ≥grade 3, necrotizing enterocolitis, cystic periventricular leukomalacia or severe bronchopulmonary dysplasia) and neonatal mortality. Additional outcome variables were Apgar score at 5 min, sepsis, and treated patent ductus arteriosus.
  
  
  RESULTS
  Accelerated villous maturation was associated with a decreased risk for Apgar score <7 at 5 min (p = 0.041). Fetal thrombosis and low placental weight were associated with an increased risk for both intrauterine fetal death (p < 0.001 and p = 0.011, respectively) and small-for-gestational age (p < 0.001 and p < 0.001, respectively).
  
  
  CONCLUSIONS
  Placental histology may have prognostic value as it appears to be associated with intrauterine fetal death, as well as with being small-for-gestational age and assignment of a low Apgar score at birth.
authors.affiliation: Department of Clinical Science, Intervention and Technology, Division of Obstetrics and Gynecology, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.|Department of Obstetrics and Gynecology, Örnsköldsviks Hospital, Örnsköldsvik, Sweden.
authors.forename: Marie-Therese
authors.initials: MT
authors.lastname: Vinnars
authors.affiliation: Department of Laboratory Medicine, Division of Pathology, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Nikos
authors.initials: N
authors.lastname: Papadogiannakis
authors.affiliation: Department of Clinical Science, Intervention and Technology, Division of Obstetrics and Gynecology, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Josefine
authors.initials: J
authors.lastname: Nasiell
authors.affiliation: Department of Neuroscience/Ophthalmology, Uppsala University, Uppsala, Sweden.
authors.forename: Gerd
authors.initials: G
authors.lastname: Holmström
authors.affiliation: Department of Clinical Science, Intervention and Technology, Division of Obstetrics and Gynecology, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Westgren
mesh_terms: D000328:Adult; D001034:Apgar Score; D005260:Female; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology; D007236:Infant, Small for Gestational Age; D010920:Placenta / Q000473:pathology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D050497:Stillbirth / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology
keywords: Histopathology; placental weight; prematurity; thrombosis; villous maturation