Preliminary Study on Neurodevelopmental Outcome and Placental Pathology among Extremely Low Birth Weight Infants.
10.14734/kjp.2015.26.1.67
- Author:
Seong Hee OH
1
;
Jong Jae KIM
;
Hyun Jeong DO
;
Byong Sop LEE
;
Ki Soo KIM
;
Ellen Ai Rhan KIM
Author Information
1. Division of Neonatology, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea. arkim@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Placenta;
Chorioamnionitis;
Underperfusion;
Neurodevelopmental;
Extremely low birth weight
- MeSH:
Biopsy;
Birth Weight;
Chorioamnionitis;
Counseling;
Ductus Arteriosus, Patent;
Female;
Gestational Age;
Head;
Humans;
Infant*;
Infant, Low Birth Weight*;
Infant, Newborn;
Intensive Care, Neonatal;
Mortality;
Odds Ratio;
Parents;
Parturition;
Pathology*;
Placenta;
Pregnancy;
Weights and Measures
- From:Korean Journal of Perinatology
2015;26(1):67-77
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To investigate the relationship between placental pathology and neurodevelopmental outcomes among extremely low birth weight (ELBW) infants. METHODS: Pathology of placentas from ELBW infants born at a tertiary neonatal intensive care unit from January 2007 to December 2012 were reviewed and placental histology was grouped into 3 categories by a designated pathologist: acute chorioamnionitis (ACA), maternal vascular underperfusion (MVU), and control group. Matched ELBW infants were tested for significant neurodevelopmental delays defined as mental developmental index (MDI) or psychomotor developmental index (PDI) <70, using Bayley Scales of Infant Development-II (BSID-II). RESULTS: The mean gestational age and birth weight of 175 infants were 27.1+/-2.5 weeks and 764.7+/-152.3 g respectively. Placental histology revealed MVU (48.0%), ACA (25.1%) and control (26.9%) in distribution. There were less significant patent ductus arteriosus in MVU group than in control group [adjusted odds ratio (OR)=0.331, P=0.011]. The frequencies of other neonatal diseases and mortality were similar in 3 groups. Sixty four of 175 infants were examined for BSID-II at mean corrected 19.9+/-3.2 months. MVU was associated with significant mental developmental delay (OR=5.185, P=0.036), but after adjustment for head circumference/weight at birth, the statistically significance of association disappeared (adjusted OR=4.391, P=0.075). ACA did not affect neonatal and neurodevelopmental outcomes. CONCLUSION: The result of placenta biopsy could be a useful tool in counseling parents for future neurodevelopmental outcome, however, further studies are required to define definitive association in between placenta biopsy and neurodevelopmental outcomes.
