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Ischemic placental disease as a risk factor for bronchopulmonary dysplasia in extremely preterm infants

Yu Ariyoshi1, Takayuki Iriyama1, Seisuke Sayama1

  • 1Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.

The Journal of Obstetrics and Gynaecology Research
|May 12, 2025
PubMed

Insights

Placental insufficiency, indicated by ischemic placental disease (IPD), significantly increases the risk of bronchopulmonary dysplasia (BPD) in extremely preterm infants. This finding highlights the critical role of placental health in neonatal outcomes.

Area of Science:

  • Neonatalogy
  • Perinatology
  • Obstetrics

Background:

  • Extremely preterm infants face significant risks of neonatal complications.
  • Placental insufficiency, including ischemic placental disease (IPD), is a known factor affecting fetal development.
  • Understanding the link between IPD and specific neonatal morbidities is crucial for improving care.

Purpose of the Study:

  • To investigate the association between placental insufficiency (IPD) and complications in extremely preterm infants.
  • To determine if IPD, preeclampsia, small-for-gestational-age (SGA), or placental abruption are risk factors for neonatal complications.
  • To analyze the incidence of bronchopulmonary dysplasia (BPD) in infants with and without IPD.

Main Methods:

  • Infants born between 22 and 28 weeks gestation were divided into IPD and non-IPD groups, matched for gestational age and sex.
  • Neonatal complications were analyzed and compared between the two groups.
  • Logistic regression was used to identify risk factors for BPD.

Main Results:

  • The IPD group had significantly lower birth weight and a higher incidence of BPD (85% vs. 48%).
  • IPD was a significant risk factor for BPD (OR: 9.4), as were preeclampsia and SGA.
  • Histological chorioamnionitis (CAM) was more prevalent in the non-IPD group and not associated with BPD.

Conclusions:

  • Placental insufficiency, specifically IPD, is strongly linked to an increased risk of BPD in extremely preterm infants.
  • Preeclampsia and SGA are also identified as significant risk factors for BPD.
  • Further research into managing IPD may help reduce BPD rates in preterm neonates.
Abstract

Keywords:
bronchopulmonary dysplasiaischemic placental diseaseplacental insufficiencypreeclampsiasmall‐for‐gestational‐age

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