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Published on: November 20, 2015
Placental pathologic score 1-2 subclinical abnormalities and early neonatal clinical indicators in term infants: a
Xinwu Mao1, Fanbin Ye1, Haidi Chang1
1Department of Pathology, The First Affiliated Hospital of Lishui University, Lishui People's Hospital Lishui 323000, Zhejiang, China.
Objective:
To explore the association between placental pathology scores of 1-2 and early neonatal clinical indicators, and evaluate the independent predictive effect of such abnormalities on composite adverse outcomes.
Methods:
This single-center retrospective case-control study enrolled 125 term singleton live births that underwent placental pathologic examination. Based on Amsterdam Consensus scoring criteria, neonates were assigned to abnormal (score 1-2, n = 63) or control (score 0, n = 62) groups. Neonatal clinical indicators within 7 days postpartum were compared between groups, followed by multivariate logistic regression and receiver operating characteristic (ROC) curve analyses.
Results:
Baseline maternal and neonatal characteristics were balanced across the two groups (all P>0.05). The abnormal group exhibited a markedly higher composite adverse outcome rate (50.8% vs. 19.4%, P<0.001), lower umbilical artery pH (7.25±0.07 vs. 7.31±0.05, P<0.001), a higher acidosis rate (19.0% vs. 0.0%, P<0.001), lower 1-h blood glucose (3.18±0.65 vs. 3.48±0.67 mmol/L, P = 0.012), and elevated C-reactive protein (CRP) levels (8.94±7.42 vs. 3.61±2.78 mg/L, P<0.001) alongside a higher proportion of CRP >10 mg/L (34.9% vs. 4.8%, P<0.001). No significant intergroup differences were observed in the incidence of clinical hypoglycemia (19.0% vs. 11.3%, P = 0.338) or intravenous antibiotic administration (3.2% vs. 4.8%, P = 0.680). Multivariate logistic regression confirmed that placental subclinical abnormalities constituted an independent risk factor for composite adverse outcome (adjusted OR = 3.779, 95% CI: 1.499-9.529, P = 0.005). The area under the ROC curve was 0.672.
Conclusions:
Placental pathology scores of 1-2 are independently associated with neonatal acidosis and elevated inflammatory markers in term neonates, and correlate with a nearly fourfold increased risk of composite adverse outcome. Mild placental subclinical abnormalities should be integrated into routine neonatal risk assessment to optimize perinatal transitional care.
