Epidemiology of placental pathology in neonatal ≤ 34 weeks gestation
| All neonates (n = 157) | Gestational age ≤ 27 weeks (n = 35) | Gestational age 28–33 weeks (n = 122) | *P value | |
|---|---|---|---|---|
| Maternal vascular underperfusion, n (%) | 48 (30.6) | 5 (14.3) | 43 (35.2) | 0.018 |
| Fetal vascular underperfusion, n (%) | 19 (12.1) | 2 (5.7) | 17 (13.9) | 0.190 |
| Acute placental inflammation, n (%) | 50 (31.8) | 15 (42.9) | 35 (28.7) | 0.114 |
| Chronic placental inflammation, n (%) | 9 (5.7) | 5 (14.3) | 4 (3.3) | 0.014 |
| Combination of placental pathology, n (%) | 31 (19.7) | 8 (22.9) | 23 (18.9) | 0.053 |
Impact of type of placental pathology on neonatal outcomes
| A. Maternal vascular underperfusion n = 48 | B. Fetal vascular underperfusion n = 19 | C. Acute placental inflammation, n = 50 | D. Chronic placental inflammation, n = 9 | E. Combination of placental pathology n = 31 | P value | |
|---|---|---|---|---|---|---|
| Birth weight (g), median (IQR) | 1510 (1154,5 – 1913,8) | 1737 (1010 – 2150) | 1482 (1090 – 1905) | 910 (839 – 1380) | 1240 (1000 – 1690) | 0,020*† |
| Gestation + days (weeks), median (IQR) | 31 (29 + 1 – 32 + 6) | 31 + 6 (29 + 6 – 33) | 30 (27 + 3 – 32 + 4) | 26 + 4 (25 + 6 – 29 + 5) | 31 (27 + 6 – 33) | 0.013*‡ |
| Placental weight (g), median (IQR) | 320 (285 – 397.5) | 350 (320 – 430) | 389 (307.5 – 442.5) | 330 (200 – 395) | 330 (260 – 400) | 0.103* |
| 1-min Apgar score, median (IQR) | 8 (6 – 10) | 10 (7 – 10) | 8 (5 – 10) | 8 (5 – 8) | 8 (5 – 10) | 0.184* |
| 5-min Apgar score, median (IQR) | 9 (7 – 10) | 9 (7 – 10) | 9 (6.8 – 10) | 7 (5.5 – 8.5) | 8 (5 – 10) | 0.405* |
| Death until hospital discharge, n (%) | 7 (15) | 1 (5.3) | 2 (4) | 3 (33) | 3 (9.7) | 0.072** |
| Any invasive mechanical ventilation, n (%) (n = 156) | 25 (52.1) | 12 (63.2) | 30 (60) | 8 (100) | 17 (54.8) | 0.117** |
| Duration of mechanical ventilation (days), median (IQR) | 1 (0 – 5) | 2 (0 – 6) | 2 (0 – 10) | 10 (2 – 29) | 2 (0 – 9) | 0.229* |
| Supplemental oxygen therapy (days), median (IQR) | 17 (6 – 30) | 22 (7 – 29) | 24 (10.8 – 43.5) | 34 (17.5 – 59) | 24 (12 – 42) | 0.089* |
| BPD | 15 (31.3) | 6 (31.6) | 22 (44) | 7 (77.8) | 15 (48.4) | 0.076§ |
| Duration of hospital stay (days), median (IQR) | 30.5 (18 – 55.8) | 31 (18 – 51) | 36 (22 – 64.5) | 49 (18 – 62) | 37 (27 – 63) | 0.205* |
Demographic and clinical data of the analysed groups
| Risk factor | No placental pathology (n = 96) | Any placental pathology (n = 157) | P value |
|---|---|---|---|
| Birth weight (g), median (IQR) | 1754 (1485,5 – 2065) | 1460 (1067,5 – 1835) | 0.001‡ |
| Gestation (completed weeks + days), median (IQR) | 32 + 0 (31 + 0 – 32 + 4) | 31 + 0 (30 + 0 – 31 + 3) | 0.001‡ |
| Maternal age (years), mean (SD) | 30 (6.4) | 29 (6.4) | 0.263† |
| Placental weight (g), Median (IQR) | 425 (370 – 480) | 350 (300 – 430) | <0.001‡ |
| pSGA, n (%) | 0 | 51 (34.2) | – |
| 1-min Apgar score, Median (IQR) | 9 (7 – 10) | 8 (6 – 10) | 0.041‡ |
| 5-min Apgar score, Median (IQR) | 9 (8 – 10) | 9 (7 – 10) | 0.081‡ |
| Sex, female (%) | 40 (41.7) | 70 (44.6) | 0.649* |
| Death until hospital discharge, n (%) | 3 (3.1) | 16 (10.2) | 0.039* |
| Any invasive mechanical ventilation, n (%) | 50 (52.1) | 92 (59) | 0.284* |
| Duration of mechanical ventilation (days), Median (IQR) | 1 (0–5) | 2 (0–7) | 0.070‡ |
| Supplemental oxygen therapy (days), median (IQR) | 18 (9–29) | 23 (8–35) | 0.097‡ |
| BPD, n (%) | 25 (26.0) | 65 (41.4) | 0.013* |
| Duration of hospital stay (days), median (IQR) | 32 (24 – 46) | 35 (22 – 58) | 0.192‡ |