Details

Autor(en) / Beteiligte

• Chalak, Lina
• Redline, Raymond W.
• Goodman, Amy M.
• Juul, Sandra E.
• Chang, Taeun
• Yanowitz, Toby D.
• Maitre, Nathalie
• Mayock, Dennis E.
• Lampland, Andrea L.
• Bendel-Stenzel, Ellen
• Riley, David
• Mathur, Amit M.
• Rao, Rakesh
• Van Meurs, Krisa P.
• Wu, Tai-Wei
• Gonzalez, Fernando F.
• Flibotte, John
• Mietzsch, Ulrike
• Sokol, Gregory M.
• Ahmad, Kaashif A.
• Baserga, Mariana
• Weitkamp, Joern-Hendrik
• Poindexter, Brenda B.
• Comstock, Bryan A.
• Wu, Yvonne W.

Titel

Acute and Chronic Placental Abnormalities in a Multicenter Cohort of Newborn Infants with Hypoxic–Ischemic Encephalopathy

Ist Teil von

• The Journal of pediatrics, 2021-10, Vol.237, p.190-196

Ort / Verlag

Elsevier Inc

Erscheinungsjahr

2021

Link zum Volltext

Quelle

Elsevier ScienceDirect Journals Complete

Beschreibungen/Notizen

• To examine the frequency of placental abnormalities in a multicenter cohort of newborn infants with hypoxic–ischemic encephalopathy (HIE) and to determine the association between acuity of placental abnormalities and clinical characteristics of HIE. Infants born at ≥36 weeks of gestation (n = 500) with moderate or severe HIE were enrolled in the High-dose Erythropoietin for Asphyxia and Encephalopathy Trial. A placental pathologist blinded to clinical information reviewed clinical pathology reports to determine the presence of acute and chronic placental abnormalities using a standard classification system. Complete placental pathologic examination was available for 321 of 500 (64%) trial participants. Placental abnormalities were identified in 273 of 321 (85%) and were more common in infants ≥40 weeks of gestation (93% vs 81%, P = .01). A combination of acute and chronic placental abnormalities (43%) was more common than either acute (20%) or chronic (21%) abnormalities alone. Acute abnormalities included meconium staining of the placenta (41%) and histologic chorioamnionitis (39%). Chronic abnormalities included maternal vascular malperfusion (25%), villitis of unknown etiology (8%), and fetal vascular malperfusion (6%). Infants with chronic placental abnormalities exhibited a greater mean base deficit at birth (−15.9 vs −14.3, P = .049) than those without such abnormalities. Patients with HIE and acute placental lesions had older mean gestational ages (39.1 vs 38.0, P < .001) and greater rates of clinically diagnosed chorioamnionitis (25% vs 2%, P < .001) than those without acute abnormalities. Combined acute and chronic placental abnormalities were common in this cohort of infants with HIE, underscoring the complex causal pathways of HIE. ClinicalTrials.gov: NCT02811263