The relationship between placental histopathology findings and perinatal outcome in preterm infants
Objective: To determine the correlation between placental histopathology findings and perinatal outcome in preterm infants. Methods: Placental histopathology in 774 neonates delivered at 24-32 weeks between 1992 and 2000 was classified as follows: 254 (33%) had histological chorioamnionitis, 263 (34...
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Veröffentlicht in: | The journal of maternal-fetal & neonatal medicine 2003-02, Vol.13 (2), p.102-109 |
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Zusammenfassung: | Objective: To determine the correlation between placental histopathology findings and perinatal outcome in preterm infants.
Methods: Placental histopathology in 774 neonates delivered
at 24-32 weeks between 1992 and 2000 was classified as follows: 254 (33%) had histological chorioamnionitis, 263 (34%) had coagulation-related lesions, 228 (30%) had vasculopathy. Perinatal outcome was
compared between cases positive and negative for each histopathological classification.
Results: Histological chorioamnionitis occurred in 46% of cases with premature rupture of membranes and
45% with preterm labor. Positivity versus negativity for histological chorioamnionitis was associated with earlier presentation (191 vs. 205 days, p = 0.0001) and delivery (199 days vs. 209 days,
p = 0.0001), increased risk of intraventricular hemorrhage (71% vs. 23%, p = 0.001, odds ratio (OR) 2.2), bronchopulmonary dysplasia (26% vs. 15%, p = 0.0001, OR 2), retinopathy (36%
vs. 24%, p = 0.001, OR 1.8), neonatal sepsis (28% vs. 13%, p = 0.0001, OR 2.5) and neonatal death (12% vs. 7%, p = 0.012, OR 2). Vasculopathy versus no vasculopathy was associated with
decreased birth weight (1245 g vs. 1341 g, p = 0.011), decreased Apgar score at 5 min (20% vs. 13%, p = 0.011, OR 1.7) and necrotizing enterocolitis (6% vs. 2%, p = 0.001, OR 4). Cases
positive for coagulation-related lesions correlated only with necrotizing enterocolitis (5% vs. 2%, p = 0.02, OR 2.6).
Conclusions: The presence of histological chorioamnionitis significantly
increases the risk of earlier delivery and neonatal mortality. Vascular and coagulation placental findings increase the risk of necrotizing enterocolitis. |
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ISSN: | 1476-7058 1476-4954 |
DOI: | 10.1080/jmf.13.2.102.109 |