Impact of multiple placental pathologies on neonatal death, bronchopulmonary dysplasia, and neurodevelopmental impairment in preterm infants
Background To determine the association of placental pathology, including multiple placental lesions, with the occurrence and severity of bronchopulmonary dysplasia (BPD), death, and neurodevelopmental impairment (NDI) in preterm infants. Method A retrospective cohort study of neonates
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| Veröffentlicht in: | Pediatric research 2020-04, Vol.87 (5), p.885-891 |
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| creator | Mir, Imran N. Chalak, Lina F. Brown, L. Steven Johnson-Welch, Sarah Heyne, Roy Rosenfeld, Charles R. Kapadia, Vishal S. |
| description | Background
To determine the association of placental pathology, including multiple placental lesions, with the occurrence and severity of bronchopulmonary dysplasia (BPD), death, and neurodevelopmental impairment (NDI) in preterm infants.
Method
A retrospective cohort study of neonates |
| doi_str_mv | 10.1038/s41390-019-0715-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7223700</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2387248624</sourcerecordid><originalsourceid>FETCH-LOGICAL-c470t-dc99cb3fb05985b35e6d7fc4b09d1db978d16e7a6a6cb6a9cf1e36aaec89ae003</originalsourceid><addsrcrecordid>eNp1kc1u1TAQhS1ERS-FB2CDLLFh0RQ7TmJ7g4QqfipVYgNry7En97py7GAnle478NA4pBSo1JXtmW_OeOYg9IqSC0qYeJcbyiSpCJUV4bStjk_QjrasRJqGP0U7QhitmJTiFD3P-YYQ2rSieYZOGRW0LuQO_bwaJ21mHAc8Ln52kwc8eW0gzNrjSc-H6OPeQcYx4AAx6DVuoSTOcZ9iMIc4LX4siXTE9phLcXb6HOtgC7-kaOEWfJzGTdGVdi6tD-wCnhLMkMZyHXSY8wt0Mmif4eXdeYa-f_r47fJLdf3189Xlh-vKNJzMlTVSmp4NPWmlaHvWQmf5YJqeSEttL7mwtAOuO92ZvtPSDBRYpzUYITWUpZyh95vutPQj2HXYpL2akhvLFCpqp_7PBHdQ-3ireF0z_lvg7Z1Aij8WyLMaXTbgvS4rWrKqWV1zJriUBX3zAL2JSwplvEIJXjeiq5tC0Y0yKeacYLj_DCVq9VptXqvitVq9VsdS8_rfKe4r_phbgHoDckmFPaS_rR9X_QWxULsP</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2387248624</pqid></control><display><type>article</type><title>Impact of multiple placental pathologies on neonatal death, bronchopulmonary dysplasia, and neurodevelopmental impairment in preterm infants</title><source>SpringerLink Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Mir, Imran N. ; Chalak, Lina F. ; Brown, L. Steven ; Johnson-Welch, Sarah ; Heyne, Roy ; Rosenfeld, Charles R. ; Kapadia, Vishal S.</creator><creatorcontrib>Mir, Imran N. ; Chalak, Lina F. ; Brown, L. Steven ; Johnson-Welch, Sarah ; Heyne, Roy ; Rosenfeld, Charles R. ; Kapadia, Vishal S.</creatorcontrib><description>Background
To determine the association of placental pathology, including multiple placental lesions, with the occurrence and severity of bronchopulmonary dysplasia (BPD), death, and neurodevelopmental impairment (NDI) in preterm infants.
Method
A retrospective cohort study of neonates <29 weeks gestational age (GA) born at Parkland Hospital from 08/2009 to 08/2012. Infants were stratified as follows: Group 1: no significant placental pathology; Group 2: single significant placental lesion; and Group 3: ≥2 placental lesions (multiple lesions). Primary outcome was death and/or BPD. Two-year neurodevelopmental follow-up was compared.
Results
In all, 42% (100/241) of infants had one placental lesion, and 34% (82/241) ≥2 lesions. As the number of the pathologic lesions increased (no lesions vs. 1 vs. ≥2), the occurrence of death or BPD increased (25%, 37%, and 52%, respectively;
P
= 0.004). Moreover, infants with multiple pathologic lesions were more likely to have NDI (29%, 29%, and 46%, respectively;
P
= 0.03). After logistic regression, infants with multiple pathologic lesions were more likely to develop moderate-to-severe BPD [
P
< 0.01; OR 3.9 (1.5–10.1)] but not NDI.
Conclusion(s)
Neonates <29 weeks GA with multiple placental pathologic lesions have an increased risk for developing BPD, suggesting an interaction between placental inflammation and vascular pathology and the pathogenesis of BPD; however, the risk of NDI is not increased.</description><identifier>ISSN: 0031-3998</identifier><identifier>EISSN: 1530-0447</identifier><identifier>DOI: 10.1038/s41390-019-0715-y</identifier><identifier>PMID: 31812153</identifier><language>eng</language><publisher>New York: Nature Publishing Group US</publisher><subject>Clinical ; Clinical Research Article ; Health risk assessment ; Lung diseases ; Medicine ; Medicine & Public Health ; Newborn babies ; Pathology ; Pediatric Surgery ; Pediatrics ; Premature babies</subject><ispartof>Pediatric research, 2020-04, Vol.87 (5), p.885-891</ispartof><rights>International Pediatric Research Foundation, Inc 2019</rights><rights>International Pediatric Research Foundation, Inc 2019.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-dc99cb3fb05985b35e6d7fc4b09d1db978d16e7a6a6cb6a9cf1e36aaec89ae003</citedby><cites>FETCH-LOGICAL-c470t-dc99cb3fb05985b35e6d7fc4b09d1db978d16e7a6a6cb6a9cf1e36aaec89ae003</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/s41390-019-0715-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/s41390-019-0715-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31812153$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mir, Imran N.</creatorcontrib><creatorcontrib>Chalak, Lina F.</creatorcontrib><creatorcontrib>Brown, L. Steven</creatorcontrib><creatorcontrib>Johnson-Welch, Sarah</creatorcontrib><creatorcontrib>Heyne, Roy</creatorcontrib><creatorcontrib>Rosenfeld, Charles R.</creatorcontrib><creatorcontrib>Kapadia, Vishal S.</creatorcontrib><title>Impact of multiple placental pathologies on neonatal death, bronchopulmonary dysplasia, and neurodevelopmental impairment in preterm infants</title><title>Pediatric research</title><addtitle>Pediatr Res</addtitle><addtitle>Pediatr Res</addtitle><description>Background
To determine the association of placental pathology, including multiple placental lesions, with the occurrence and severity of bronchopulmonary dysplasia (BPD), death, and neurodevelopmental impairment (NDI) in preterm infants.
Method
A retrospective cohort study of neonates <29 weeks gestational age (GA) born at Parkland Hospital from 08/2009 to 08/2012. Infants were stratified as follows: Group 1: no significant placental pathology; Group 2: single significant placental lesion; and Group 3: ≥2 placental lesions (multiple lesions). Primary outcome was death and/or BPD. Two-year neurodevelopmental follow-up was compared.
Results
In all, 42% (100/241) of infants had one placental lesion, and 34% (82/241) ≥2 lesions. As the number of the pathologic lesions increased (no lesions vs. 1 vs. ≥2), the occurrence of death or BPD increased (25%, 37%, and 52%, respectively;
P
= 0.004). Moreover, infants with multiple pathologic lesions were more likely to have NDI (29%, 29%, and 46%, respectively;
P
= 0.03). After logistic regression, infants with multiple pathologic lesions were more likely to develop moderate-to-severe BPD [
P
< 0.01; OR 3.9 (1.5–10.1)] but not NDI.
Conclusion(s)
Neonates <29 weeks GA with multiple placental pathologic lesions have an increased risk for developing BPD, suggesting an interaction between placental inflammation and vascular pathology and the pathogenesis of BPD; however, the risk of NDI is not increased.</description><subject>Clinical</subject><subject>Clinical Research Article</subject><subject>Health risk assessment</subject><subject>Lung diseases</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Newborn babies</subject><subject>Pathology</subject><subject>Pediatric Surgery</subject><subject>Pediatrics</subject><subject>Premature babies</subject><issn>0031-3998</issn><issn>1530-0447</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp1kc1u1TAQhS1ERS-FB2CDLLFh0RQ7TmJ7g4QqfipVYgNry7En97py7GAnle478NA4pBSo1JXtmW_OeOYg9IqSC0qYeJcbyiSpCJUV4bStjk_QjrasRJqGP0U7QhitmJTiFD3P-YYQ2rSieYZOGRW0LuQO_bwaJ21mHAc8Ln52kwc8eW0gzNrjSc-H6OPeQcYx4AAx6DVuoSTOcZ9iMIc4LX4siXTE9phLcXb6HOtgC7-kaOEWfJzGTdGVdi6tD-wCnhLMkMZyHXSY8wt0Mmif4eXdeYa-f_r47fJLdf3189Xlh-vKNJzMlTVSmp4NPWmlaHvWQmf5YJqeSEttL7mwtAOuO92ZvtPSDBRYpzUYITWUpZyh95vutPQj2HXYpL2akhvLFCpqp_7PBHdQ-3ireF0z_lvg7Z1Aij8WyLMaXTbgvS4rWrKqWV1zJriUBX3zAL2JSwplvEIJXjeiq5tC0Y0yKeacYLj_DCVq9VptXqvitVq9VsdS8_rfKe4r_phbgHoDckmFPaS_rR9X_QWxULsP</recordid><startdate>20200401</startdate><enddate>20200401</enddate><creator>Mir, Imran N.</creator><creator>Chalak, Lina F.</creator><creator>Brown, L. Steven</creator><creator>Johnson-Welch, Sarah</creator><creator>Heyne, Roy</creator><creator>Rosenfeld, Charles R.</creator><creator>Kapadia, Vishal S.</creator><general>Nature Publishing Group US</general><general>Nature Publishing Group</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20200401</creationdate><title>Impact of multiple placental pathologies on neonatal death, bronchopulmonary dysplasia, and neurodevelopmental impairment in preterm infants</title><author>Mir, Imran N. ; Chalak, Lina F. ; Brown, L. Steven ; Johnson-Welch, Sarah ; Heyne, Roy ; Rosenfeld, Charles R. ; Kapadia, Vishal S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c470t-dc99cb3fb05985b35e6d7fc4b09d1db978d16e7a6a6cb6a9cf1e36aaec89ae003</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Clinical</topic><topic>Clinical Research Article</topic><topic>Health risk assessment</topic><topic>Lung diseases</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Newborn babies</topic><topic>Pathology</topic><topic>Pediatric Surgery</topic><topic>Pediatrics</topic><topic>Premature babies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mir, Imran N.</creatorcontrib><creatorcontrib>Chalak, Lina F.</creatorcontrib><creatorcontrib>Brown, L. Steven</creatorcontrib><creatorcontrib>Johnson-Welch, Sarah</creatorcontrib><creatorcontrib>Heyne, Roy</creatorcontrib><creatorcontrib>Rosenfeld, Charles R.</creatorcontrib><creatorcontrib>Kapadia, Vishal S.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pediatric research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mir, Imran N.</au><au>Chalak, Lina F.</au><au>Brown, L. Steven</au><au>Johnson-Welch, Sarah</au><au>Heyne, Roy</au><au>Rosenfeld, Charles R.</au><au>Kapadia, Vishal S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of multiple placental pathologies on neonatal death, bronchopulmonary dysplasia, and neurodevelopmental impairment in preterm infants</atitle><jtitle>Pediatric research</jtitle><stitle>Pediatr Res</stitle><addtitle>Pediatr Res</addtitle><date>2020-04-01</date><risdate>2020</risdate><volume>87</volume><issue>5</issue><spage>885</spage><epage>891</epage><pages>885-891</pages><issn>0031-3998</issn><eissn>1530-0447</eissn><abstract>Background
To determine the association of placental pathology, including multiple placental lesions, with the occurrence and severity of bronchopulmonary dysplasia (BPD), death, and neurodevelopmental impairment (NDI) in preterm infants.
Method
A retrospective cohort study of neonates <29 weeks gestational age (GA) born at Parkland Hospital from 08/2009 to 08/2012. Infants were stratified as follows: Group 1: no significant placental pathology; Group 2: single significant placental lesion; and Group 3: ≥2 placental lesions (multiple lesions). Primary outcome was death and/or BPD. Two-year neurodevelopmental follow-up was compared.
Results
In all, 42% (100/241) of infants had one placental lesion, and 34% (82/241) ≥2 lesions. As the number of the pathologic lesions increased (no lesions vs. 1 vs. ≥2), the occurrence of death or BPD increased (25%, 37%, and 52%, respectively;
P
= 0.004). Moreover, infants with multiple pathologic lesions were more likely to have NDI (29%, 29%, and 46%, respectively;
P
= 0.03). After logistic regression, infants with multiple pathologic lesions were more likely to develop moderate-to-severe BPD [
P
< 0.01; OR 3.9 (1.5–10.1)] but not NDI.
Conclusion(s)
Neonates <29 weeks GA with multiple placental pathologic lesions have an increased risk for developing BPD, suggesting an interaction between placental inflammation and vascular pathology and the pathogenesis of BPD; however, the risk of NDI is not increased.</abstract><cop>New York</cop><pub>Nature Publishing Group US</pub><pmid>31812153</pmid><doi>10.1038/s41390-019-0715-y</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Pediatric research, 2020-04, Vol.87 (5), p.885-891 |
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| source | SpringerLink Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Clinical Clinical Research Article Health risk assessment Lung diseases Medicine Medicine & Public Health Newborn babies Pathology Pediatric Surgery Pediatrics Premature babies |
| title | Impact of multiple placental pathologies on neonatal death, bronchopulmonary dysplasia, and neurodevelopmental impairment in preterm infants |
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