Abstract
Background: Little is known about the association of placental pathology and neurological morbidity shortly after birth in preterm infants. Neurological condition during this period can be evaluated by the quality of general movements (GMs).
Aim: To determine whether placental pathology was associated with neurological morbidity in preterm infants during the first two weeks after birth.
Methods: Placentas from 27 singleton, preterm infants (gestational age 26-31 weeks, birth weight 615-2250 grams) were assessed for placental lesions: maternal vascular underperfusion, ascending infection, villitis placentae of unknown etiology (VUE), chronic deciduitis, fetal thrombotic vasculopathy (FTV), meconium associated changes, and other unspecified. The presence of elevated nucleated red blood cells (NRBCs) was also assessed. Neurological morbidity was determined by the quality of GMs as normal, abnormal or hypokinetic, on postnatal day 1-5, 8, and 15. Additionally a motor-optimality-score (MOS) was obtained.
Results: Examination of the placentas revealed: maternal vascular underperfusion (n=20), ascending infection (n=9), VUE (n=5), chronic deciduitis (n=9), FTV (n=5), meconium associated changes (n=6), and elevated NRBCs (n=6). FTV was associated with abnormal GMs on day 3 (p=0.043). Maternal vascular underperfusion was associated with low MOS on day 8 (p=0.064), while ascending infection was associated with high MOS on day 8 (p=0.004). No association existed between other placental lesions and GMs or MOS.
Conclusions: Placental lesions have limited effects on early neurological morbidity in preterm infants. Only on some days after birth, FTV and maternal vascular underperfusion were associated with neurological morbidity, whereas ascending infection was associated with better quality of GMs.
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Roescher, A., Timmer, A., Verhagen, E. et al. 566 Placental Pathology is Associated with Neurological Development in Preterm Infants During the First Two Weeks After Birth. Pediatr Res 68 (Suppl 1), 290 (2010). https://doi.org/10.1203/00006450-201011001-00566
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DOI: https://doi.org/10.1203/00006450-201011001-00566