Placental histological features and neurodevelopmental outcomes at two years in very low birth weight infants

Abstract Background We evaluated the rates of placental pathological lesions and their relationship with two-year neurodevelopmental outcomes in very-low-birthweight (VLBW) infants Methods A cohort observational study comprising 595 VLBW infants during 2007-2015. Neurodevelopmental assessment was carried out at 24 months corrected age. Results In univariate analysis the rates of survival with normal neurodevelopmental outcomes were lower in pregnancies with severe histological chorioamnionitis (38/43, 88.4% as compared to 305/450, 67.8%), severe maternal vascular malperfusion (MVM) (17/37, 45.9% as compared to 326/492 ,66.3%), and intravillous hemorrhage (37/82, 45.1% as compared to 306/449, 68.1%). In logistic models, severe MVM (Adj.OR=0.45, 95%CI=0.22-0.92), severe fetal vascular malperfusion (FVM) (Adj.OR=0.46, 95%CI=0.22-0.45) and intravillous hemorrhage (Adj.OR= 0.38, 95%CI=0.22-0.62) were associated with lower rates of infant survival with normal neurodevelopmental outcome. FVM (Adj.OR=0.46, 95%CI=0.21-0.97) and intravillous hemorrhage (Adj.OR=0.37,95%CI =0.22-0.62) were also the only placental lesions which were independent predictors of a lower rate of intact survival in stepwise analysis for prognostic factors of the entire cohort. Conclusions Placental pathological findings such as severe MVM, FVM and intravillous hemorrhage are significant predictors of neonatal survival and subsequent adverse neurodevelopmental outcomes. Data on the placental pathology could be useful in the neurodevelopmental follow-up of VLBW infants.