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Acta Obstet Gynecol Scand. 2015 Jun;94(6):584-90. doi: 10.1111/aogs.12610. Epub 2015 Mar 9.

Placental pathology in relation to stillbirth and neonatal outcome in an extremely preterm population: a prospective cohort study.

Author information

1
Department of Clinical Science, Intervention and Technology, Division of Obstetrics and Gynecology, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
2
Department of Obstetrics and Gynecology, Örnsköldsviks Hospital, Örnsköldsvik, Sweden.
3
Department of Laboratory Medicine, Division of Pathology, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
4
Department of Neuroscience/Ophthalmology, Uppsala University, Uppsala, Sweden.

Abstract

OBJECTIVE:

To study associations between placental histopathology and stillbirth as well as neonatal outcome in a population born extremely preterm.

DESIGN:

Prospective cohort study.

SETTING:

Stockholm, Sweden.

POPULATION:

167 infants born <27 gestational weeks during 2004-2007.

METHODS:

One senior perinatal pathologist, blinded to outcome data, evaluated all placental slides.

MAIN OUTCOME MEASURES:

Intrauterine fetal death, small-for-gestational age, major neonatal morbidity (intraventricular hemorrhage ≥grade 3, retinopathy of prematurity ≥grade 3, necrotizing enterocolitis, cystic periventricular leukomalacia or severe bronchopulmonary dysplasia) and neonatal mortality. Additional outcome variables were Apgar score at 5 min, sepsis, and treated patent ductus arteriosus.

RESULTS:

Accelerated villous maturation was associated with a decreased risk for Apgar score <7 at 5 min (p = 0.041). Fetal thrombosis and low placental weight were associated with an increased risk for both intrauterine fetal death (p < 0.001 and p = 0.011, respectively) and small-for-gestational age (p < 0.001 and p < 0.001, respectively).

CONCLUSION:

Placental histology may have prognostic value as it appears to be associated with intrauterine fetal death, as well as with being small-for-gestational age and assignment of a low Apgar score at birth.

KEYWORDS:

Histopathology; placental weight; prematurity; thrombosis; villous maturation

PMID:
25708414
DOI:
10.1111/aogs.12610
[Indexed for MEDLINE]

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