MORPHOFUNCTIONAL FEATURES OF THE PLACENTA OF NEWBORNS IN BIRTH-INDUCED CRITICAL CONDITIONS: THE RESULTS OF A RETROSPECTIVE COHORT STUDY

Abstract

Background.  The placenta condition is the health marker of newborns  and it can be considered  in the early diagnosis  of the development of severe pathological conditions in a child. Objective:  Our aim was to study the relationship between the placenta characteristics and the risk of a birth-induced critical condition in a child and the risk of having children with the APGAR score of < 4 points.Methods. The data of macro- and microscopic studies of the placenta of newborns who have experienced birth-induced critical conditions was retrospectively  analyzed. Birth-induced  critical conditions were the APGAR score at 1 min after birth < 4 points and/or the presence of severe perinatal hypoxia, cerebral ischemia requiring respiratory support and intensive care in the intensive care unit.Results.  We examined 92 placentas of mothers who gave birth to children in a critical condition. Depending on the APGAR score at 1 min after birth, the main group (n = 56, < 4 points) and the comparison  group (n = 36, > 4 points) were singled out. In multivariate analysis, it was established  that the appearance  of a birth-induced  critical condition with the APGAR score < 4 points was associated with pathological attachment of the umbilical cord (odds ratio, OR, 2.8, 95% confidence interval, CI, 1.1–7.0),  placenta weight (OR 5.4, 95% CI 1.9–14.9),  signs of chronic fetoplacental  insufficiency (OR 7.3, 95% CI 2.9–18.8), impaired blood circulation in the placenta (OR 13.7, 95% CI 4.7–39.3), placental hypoplasia (OR 8.9, 95% CI 2.4–32.4), fetal-placental  ratio (OR 8.9, 95% CI 2.4–32.4)  as well as low birth weight of a newborn (OR 2.9, 95% CI 1.2–6.9). Conclusion. Morphological characteristics of the placenta are prognostic markers for the development of critical conditions with the APGAR score at birth < 4 points.