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Published on: November 20, 2015
Ischemic placental disease and risks of perinatal mortality and morbidity and neurodevelopmental outcomes
Cande V Ananth1, Alexander M Friedman2
1Department 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.
Insights
Ischemic placental disease, including preeclampsia and growth restriction, elevates risks for stillbirth, infant mortality, and neurodevelopmental issues. These risks are most pronounced in preterm infants, highlighting the need for clinical interventions.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Neonatal Health
Background:
- Preeclampsia, intrauterine growth restriction, and placental abruption are severe obstetric complications.
- These conditions collectively form the syndrome of ischemic placental disease.
- Ischemic placental disease significantly contributes to perinatal morbidity and mortality.
Purpose of the Study:
- To review the risks of stillbirth, neonatal, and infant mortality associated with ischemic placental disease.
- To examine the risks of neonatal morbidity and neurodevelopmental outcomes in relation to ischemic placental disease.
- To synthesize findings from population-based studies on adverse perinatal outcomes.
Main Methods:
- Literature review focusing on population-based studies.
- Synthesis of existing research on ischemic placental disease and perinatal outcomes.
- Analysis of risks for mortality and neurodevelopmental deficits.
Main Results:
- Each of the three complications, despite low prevalence, is linked to increased risks of adverse perinatal and infant outcomes.
- Neurodevelopmental deficits are also associated with these conditions.
- The heightened perinatal risks are most significant during the preterm period.
Conclusions:
- Ischemic placental disease poses substantial risks to perinatal and infant health, including neurodevelopmental issues.
- Preterm birth exacerbates the adverse outcomes associated with ischemic placental disease.
- Developing effective clinical interventions to reduce the risks of ischemic placental disease is crucial.
Abstract:
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.
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