Placenta Pathology From Term Born Neonates With Normal or Adverse Outcome

Area of Science:

• Perinatal Medicine
• Pathology
• Neonatology

Background:

• Limited data exists on the frequency of umbilical cord and placental abnormalities linked to term infant mortality or morbidity.
• Understanding these placental pathologies is crucial for improving perinatal outcomes.

Purpose of the Study:

• To investigate the association between placental abnormalities and adverse outcomes in term neonates.
• To identify specific placental pathologies correlating with stillbirth, neonatal death, and intensive care unit admissions.

Main Methods:

• A case-control study comparing placentas from stillbirths (antepartum and intrapartum), neonatal deaths, and neonatal intensive care unit admissions with controls (normal term pregnancies).
• Histopathological examination of placentas to identify abnormalities such as low weight, villous formation, hypercoiling, villitis, chorioamnionitis, and funisitis.

Main Results:

• Placentas from stillbirths exhibited two or more abnormalities in 80% of cases, compared to 70% in controls.
• Antepartum stillbirth placentas showed low weight and reduced terminal villi formation.
• Severe chronic villitis was predominantly found in antepartum stillbirths, while chorioamnionitis and funisitis were more frequent in stillbirth and neonatal intensive care unit groups.

Conclusions:

• Multiple placental abnormalities are significantly more prevalent in term neonates with severe perinatal morbidity and mortality.
• These placental findings are likely associated with impaired oxygen transfer or inflammatory processes.
• Identifying these placental markers can aid in risk assessment and management of high-risk pregnancies.