Placental pathology and neonatal encephalopathy

Area of Science:

• Obstetrics and Gynecology
• Neonatal Medicine
• Pathology

Background:

• Neonatal encephalopathy (NE) is a critical global health issue causing significant neonatal morbidity and mortality.
• The placenta's role in NE pathogenesis is suspected but not fully elucidated, with limited evidence on specific placental factors.
• Understanding placental contributions is crucial for improving NE diagnosis and management.

Purpose of the Study:

• To review and synthesize current knowledge on the placenta's role in neonatal encephalopathy.
• To focus on placental factors contributing to NE, particularly in the context of hypoxia-ischemia.
• To identify key placental pathologies associated with NE development.

Main Methods:

• Systematic review of 26 original articles and review papers.
• Identification and analysis of themes related to placental pathology and NE.
• Synthesis of findings on fetal vascular malperfusion, placental inflammation, and maternal vascular malperfusion.

Main Results:

• Fetal vascular malperfusion, including umbilical cord pathology, is significantly associated with NE.
• Inflammatory changes within the placenta are implicated in NE pathogenesis.
• Maternal vascular malperfusion, including reduced placental weight, is a key factor in NE development.

Conclusions:

• Placental pathology, encompassing fetal and maternal vascular malperfusion and inflammation, is integral to NE development.
• Further research into antenatal screening and placental histology can enhance identification of at-risk fetuses.
• Elucidating the placenta-NE relationship may lead to improved antenatal surveillance and interventions.