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Placental findings among newborns with hypoxic ischemic encephalopathy

Abstract

Objective

To determine if pre-specified placental abnormalities among newborns with hypoxic–ischemic encephalopathy (HIE) differ compared to newborns admitted to a NICU without encephalopathy.

Study Design

Retrospective case–control study of newborns with HIE (2006–2014) and controls matched for birth year, gestational age, weight, and gender. One pathologist reviewed archived placental sections using pre-specified criteria.

Results

Sixty-seven newborns had HIE, 46 had available placentas and were matched with 92 controls. HIE had more maternal vascular malperfusion (46% vs 25%, p = 0.02), fetal vascular malperfusion (13% vs 0%, p < 0.001), and clinical abruption (22% vs 4%, p = 0.001). Controls had more normal placentas (29% vs 7%, p = 0.002), and chorioamnionitis (30% vs 9%, p = 0.005). Pre-specified placental lesions occurred in 87% of HIE and 65% of controls (p = 0.008) and identified >90% of primary diagnoses.

Conclusions

Pre-specified placental lesions identified nearly all abnormalities in HIE and represented both acute and chronic processes.

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Funding

Financial support for this study was provided by the Department of Pediatrics, Women and Infants Hospital of Rhode Island. The study design, collection, analysis and interpretation of data and the writing of this report is a product of the involved investigators and the Department of Pediatrics did not play a role in any aspect of the study.

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Correspondence to Abbot R. Laptook.

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Bingham, A., Gundogan, F., Rand, K. et al. Placental findings among newborns with hypoxic ischemic encephalopathy. J Perinatol 39, 563–570 (2019). https://doi.org/10.1038/s41372-019-0334-9

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