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Placental Changes and Neuropsychological Development in Children-A Systematic Review
Maria Lodefalk1,2, Felix Chelslín1, Johanna Patriksson Karlsson2
1Department of Pediatrics, Faculty of Medicine and Health, Örebro University, 701 82 Örebro, Sweden.
Insights
This review found limited evidence linking placental changes to childhood neuropsychological outcomes. However, placental size may affect boys
Area of Science:
- Neuroscience
- Developmental Biology
- Pediatrics
Background:
- Placental dysfunction is linked to increased offspring disease risk.
- Understanding associations between placental pathology and later-life neuropsychological outcomes is crucial.
Approach:
- Systematic review of human studies on placental variables and neuropsychological outcomes.
- Searched MEDLINE and EMBASE databases (last search May 2022).
- Assessed risk of bias using ROBINS-I and performed narrative synthesis.
Key Points:
- 16 studies (15,862 participants) were included.
- 75% reported an association, but publication bias was indicated.
- Limited evidence for strong associations, with inconsistencies noted.
Conclusions:
- No strong evidence links pathological placental changes to childhood neuropsychological outcomes post-neonatal period.
- Placental size association with mental health in boys suggests sexual dimorphism.
- Male fetuses may have increased vulnerability due to placental factors.
Abstract:
Placental dysfunction may increase the offspring's later-life disease risk. The objective of this systematic review was to describe associations between pathological placental changes and neuropsychological outcomes in children after the neonatal period. The inclusion criteria were human studies; original research; direct placental variables; neuropsychological outcomes; and analysis between their associations. The exclusion criterion was the offspring's age-0-28 days or >19 years. The MEDLINE and EMBASE databases were last searched in May 2022. We utilized the ROBINS-I for the risk of bias assessment and performed a narrative synthesis. In total, 3252 studies were identified, out of which 16 were included (i.e., a total of 15,862 participants). Half of the studies were performed on children with neonatal complications, and 75% of the studies reported an association between a placental change and an outcome; however, following the completion of the funnel plots, a risk of publication bias was indicated. The largest study described a small association between placental size and a risk of psychiatric symptoms in boys only. Inconsistency between the studies limited the evidence in this review. In general, no strong evidence was found for an association between pathological placental changes and childhood neuropsychological outcomes after the neonatal period. However, the association between placental size and mental health in boys indicates a placental sexual dimorphism, thereby suggesting an increased vulnerability for male fetuses.
