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The placenta in infants >36 weeks gestation with neonatal encephalopathy: a case control study
  1. Breda C Hayes1,
  2. Sharon Cooley2,
  3. Jennifer Donnelly2,
  4. Elaine Doherty3,
  5. Andrea Grehan1,
  6. Cathy Madigan3,
  7. Cliona McGarvey4,
  8. Siobhan Mulvany1,
  9. Stephanie Ryan5,
  10. John Gillian6,
  11. Michael P Geary2,
  12. Tom G Matthews1,2,
  13. Mary D King3
  1. 1Department of Neonatology, Rotunda Hospital, Dublin, Ireland
  2. 2Department of Obstetrics and Gynaecology, Rotunda Hospital, Dublin, Ireland
  3. 3Department of Neurology and Clinical Neurophysiology, The Children's University Hospital, Dublin, Ireland
  4. 4Irish National Sudden Infant Death Register, The Childrens University Hospital, Dublin, Ireland
  5. 5Department of Radiology, Rotunda Hospital, Dublin, Ireland
  6. 6Department of Pathology, Rotunda Hospital, Dublin, Ireland
  1. Correspondence to Breda C Hayes, Department of Pediatrics, Rotunda Hospital, Dublin 1, Ireland; breda.hayes{at}childrens.harvard.edu or bredahayes{at}hotmail.com

Abstract

Objective To determine placental characteristics associated with neonatal encephalopathy (NE) and correlate these with short- and long-term neurodevelopmental outcome.

Design Case/control study.

Setting Neonatal Intensive Care Unit, Rotunda Hospital, Dublin, Ireland.

Patients Newborns ≥36 weeks gestation, with NE (cases). Healthy term newborns (controls).

Interventions Placental pathology was obtained from the official placental report. Brain MRI was blindly reviewed. Children were assessed using a variety of standardised assessments. Data were analysed using multinomial logistic regression analysis.

Main outcome measures RRR for grade of encephalopathy. OR for neurodevelopmental outcome.

Results Placental reports were available on 141 cases (76 grade 1; 46 grade 2; 19 grade 3) and 309 control infants. Meconium phagocytosis, haemorrhage, raised placental to birth weight ratio and/or markers of infection/inflammation were independently associated with NE and showed a synergistic effect, when combined, for short- and long-term impairments.

Conclusions Evaluation of the mechanisms leading to the placental characteristics identified may help to characterise the causal pathway of NE.

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Footnotes

  • Funding Funding for this study was provided by the Friends of The Rotunda. The Friends of The Rotunda is an official fundraising arm and registered Charity (CHY240) of The Rotunda Hospital.

  • Competing interests None.

  • Ethics approval Rotunda Research ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data sharing from the corresponding author at breda.hayes{at}childrens.harvard.edu.

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