title: Placental Complications and Bronchopulmonary Dysplasia: EPIPAGE-2 Cohort Study.
abstract: OBJECTIVE
  To investigate the relationship between placenta-mediated pregnancy complications and bronchopulmonary dysplasia (BPD) in very preterm infants.
  
  
  METHODS
  National prospective population-based cohort study including 2697 singletons born before 32 weeks' gestation. The main outcome measure was moderate to severe BPD. Three groups of placenta-mediated pregnancy complications were compared with no placenta-mediated complications: maternal disorders only (gestational hypertension or preeclampsia), fetal disorders only (antenatal growth restriction), and both maternal and fetal disorders.
  
  
  RESULTS
  Moderate to severe BPD rates were 8% in infants from pregnancies with maternal disorders, 15% from both maternal and fetal disorders, 23% from fetal disorders only, and 9% in the control group (P < .001). When we adjusted for gestational age, the risk of moderate to severe BPD was greater in the groups with fetal disorders only (odds ratio [OR] = 6.6; 95% confidence interval [CI], 4.1-10.7), with maternal and fetal disorders (OR = 3.7; 95% CI, 2.5-5.5), and with maternal disorders only (OR = 1.7; 95% CI, 1.0-2.7) than in the control group. When we also controlled for birth weight, the relationship remained in groups with fetal disorders only (OR = 4.2; 95% CI, 2.1-8.6) and with maternal and fetal disorders (OR = 2.1; 95% CI, 1.1-3.9).
  
  
  CONCLUSIONS
  Placenta-mediated pregnancy complications with fetal consequences are associated with moderate to severe BPD in very preterm infants independently of gestational age and birth weight, but isolated maternal hypertensive disorders are not. Fetal growth restriction, more than birth weight, could predispose to impaired lung development.
authors.affiliation: INSERM U1153, Epidemiology and Statistics Sorbonne Paris Cité Research Center, Obstetrical, Perinatal and Pediatric Epidemiology Team, Paris, France; DHU Risk in Pregnancy, Cochin Hotel-Dieu Hospital, Assistance-Publique Hôpitaux de Paris, Paris, France; heloise.torchin@inserm.fr.
authors.forename: Héloïse
authors.initials: H
authors.lastname: Torchin
authors.affiliation: INSERM U1153, Epidemiology and Statistics Sorbonne Paris Cité Research Center, Obstetrical, Perinatal and Pediatric Epidemiology Team, Paris, France; DHU Risk in Pregnancy, Cochin Hotel-Dieu Hospital, Assistance-Publique Hôpitaux de Paris, Paris, France; Paris Descartes University, Paris, France; Unité de Recherche Clinique - Centre d' Investigation Clinique;
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Ancel
authors.affiliation: INSERM U1153, Epidemiology and Statistics Sorbonne Paris Cité Research Center, Obstetrical, Perinatal and Pediatric Epidemiology Team, Paris, France; DHU Risk in Pregnancy, Cochin Hotel-Dieu Hospital, Assistance-Publique Hôpitaux de Paris, Paris, France; Paris Descartes University, Paris, France; Maternité Port-Royal, and.
authors.forename: François
authors.initials: F
authors.lastname: Goffinet
authors.affiliation: Maternite Regionale Universitaire, Neonatology, Nancy, France; and.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Hascoët
authors.affiliation: Jeanne de Flandre Hospital, Department of Neonatology CHRU de Lille, Lille Cedex, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Truffert
authors.affiliation: INSERM U1153, Epidemiology and Statistics Sorbonne Paris Cité Research Center, Obstetrical, Perinatal and Pediatric Epidemiology Team, Paris, France;
authors.forename: Diep
authors.initials: D
authors.lastname: Tran
authors.affiliation: INSERM U1153, Epidemiology and Statistics Sorbonne Paris Cité Research Center, Obstetrical, Perinatal and Pediatric Epidemiology Team, Paris, France;
authors.forename: Cécile
authors.initials: C
authors.lastname: Lebeaux
authors.affiliation: DHU Risk in Pregnancy, Cochin Hotel-Dieu Hospital, Assistance-Publique Hôpitaux de Paris, Paris, France; Paris Descartes University, Paris, France; Service de Médecine et Réanimation Néonatales de Port-Royal, Assistance Publique, Hôpitaux de Paris, Hôpital Cochin, Paris, France;
authors.forename: Pierre-Henri
authors.initials: PH
authors.lastname: Jarreau
mesh_terms: D000328:Adult; D001724:Birth Weight; D001997:Bronchopulmonary Dysplasia / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D016017:Odds Ratio; D010920:Placenta / Q000473:pathology*; D011247:Pregnancy; D011248:Pregnancy Complications; D011446:Prospective Studies