Placental Findings in Infants Gestational Age &lt; 34 Weeks and Impact on Short-Term Outcomes

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^‡

IQR – interquartile range (25% – 75%); SD – standard deviation; BPD – bronchopulmonary dysplasia

* Chi-square test

† Student's T test

‡ Mann–Whitney U test

Table 2.

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

* Chi-square test

Table 3.

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^*

IQR – interquartile range (25% – 75%); BPD – bronchopulmonary dysplasia

* Kruskal Wallis test (Post hoc Conover);

§ Chi-Square Test;

** Fisher's Exact Test

† at the level of P < 0.05 there are significant differences A vs. D; B vs. D; B vs. E; C vs. D

‡ at the level of P < 0.05 there are significant differences A vs. D; B vs. D; C vs. D; D vs. E

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DOI: https://doi.org/10.34763/jmotherandchild.20222601.d-23-00017 | Journal eISSN: 2719-535X | Journal ISSN: 2719-6488

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Language: English

Page range: 168 - 175

Submitted on: Jan 26, 2023

Accepted on: Sep 29, 2023

Published on: Nov 3, 2023

Published by: Institute of Mother and Child

In partnership with: Paradigm Publishing Services

Publication frequency: 1 issue per year

Keywords:

placenta,

death until discharge,

premature neonates,

bronchopulmonary dysplasia,

Related subjects:

Pediatrics and juvenile medicine,

Paediatric haematology and oncology,

Public health

© 2023 Krešimir Šantić, Borna Biljan, Martina Kos, Ivana Serdarušić, Jasmina Rajc, Darjan Kardum, published by Institute of Mother and Child
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 27 (2023): Issue 1 (June 2023)