Gross and Histologic Placental Abnormalities Associated With Neonatal Hypoxic-Ischemic Encephalopathy

Author:

Kim Charlotte F.12,Carreon Chrystalle Katte13,James Kaitlyn E.4,Bates Sara V.56,Mueller Sarah B.37,Boyd Theonia K.12,Roberts Drucilla J.37

Affiliation:

1. Department of Pathology, Boston Children’s Hospital, Boston, MA, USA

2. Department of Pathology and Immunology, Texas Children’s Hospital, Houston, TX, USA

3. Department of Pathology, Harvard Medical School, Boston, MA, USA

4. Department of Obstetrics, Gynecology, and Reproductive Biology, Massachusetts General Hospital, Boston, MA, USA

5. Department of Neonatology and Newborn Medicine, Massachusetts General Hospital, Boston, MA, USA

6. Department of Pediatrics, Harvard Medical School, Boston, MA, USA

7. Department of Pathology, Massachusetts General Hospital, Boston, MA, USA

Abstract

Objective: To elucidate particular placental pathology findings that are associated with hypoxic ischemic encephalopathy (HIE) and determine which patterns are associated with adverse fetal/neonatal outcomes. Study Design: Multi-institutional retrospective case-control study of newborns with HIE (2002–2022) and controls. Four perinatal pathologists performed gross and histologic evaluation of placentas of cases and controls. Results: A total of 265 placentas of neonates with HIE and 122 controls were examined. Infants with HIE were more likely to have anatomic umbilical cord abnormalities (19.7% vs 7.4%, P = .003), fetal inflammatory response in the setting of amniotic fluid infection (27.7% vs 13.9%, P = .004), and fetal vascular malperfusion (30.6% vs 9.0%, P = <.001) versus controls. Fetal vascular malperfusion with maternal vascular malperfusion was more common in those who died of disease ( P = .01). Conclusion: Placental pathology examination of neonates with HIE may improve our understanding of this disorder and its adverse outcomes.

Publisher

SAGE Publications

Subject

General Medicine,Pathology and Forensic Medicine,Pediatrics, Perinatology and Child Health

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