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Published on: November 20, 2015
The placenta in infants >36 weeks gestation with neonatal encephalopathy: a case control study
Breda C Hayes1, Sharon Cooley, Jennifer Donnelly
1Department of Pediatrics, Rotunda Hospital, Dublin 1, Ireland. breda.hayes@childrens.harvard.edu
Objective:
To determine placental characteristics associated with neonatal encephalopathy (NE) and correlate these with short- and long-term neurodevelopmental outcome.
Design:
Case/control study.
Setting:
Neonatal Intensive Care Unit, Rotunda Hospital, Dublin, Ireland.
Patients:
Newborns ≥36 weeks gestation, with NE (cases). Healthy term newborns (controls).
Interventions:
Placental pathology was obtained from the official placental report. Brain MRI was blindly reviewed. Children were assessed using a variety of standardised assessments. Data were analysed using multinomial logistic regression analysis.
Main Outcome Measures:
RRR for grade of encephalopathy. OR for neurodevelopmental outcome.
Results:
Placental reports were available on 141 cases (76 grade 1; 46 grade 2; 19 grade 3) and 309 control infants. Meconium phagocytosis, haemorrhage, raised placental to birth weight ratio and/or markers of infection/inflammation were independently associated with NE and showed a synergistic effect, when combined, for short- and long-term impairments.
Conclusions:
Evaluation of the mechanisms leading to the placental characteristics identified may help to characterise the causal pathway of NE.
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