Periventricular Leukomalacia and Placental Histopathologic Abnormalities
- 1 November 2009
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Obstetrics & Gynecology
- Vol. 114 (5), 1115-1120
- https://doi.org/10.1097/aog.0b013e3181bdcfc4
Abstract
To estimate whether there are placental histopathologic abnormalities associated with neonatal periventricular leukomalacia (PVL), a major precursor of cerebral palsy.This is a case-control study of 167 neonates born between 23 and 34 weeks of gestation diagnosed with PVL by head ultrasonography within 6 weeks of birth, and 167 control neonates without neurologic morbidity matched by gestational age. Placentas for both case neonates and control neonates were reviewed by two perinatal pathologists who were blinded to neonatal course.Neonates with PVL were significantly more likely to have positive neonatal blood (28.7%, 16.8%, P=.001) and cerebrospinal fluid (14.4%, 4.8%, P=.007) cultures. The ratio of placental weight to birth weight did not differ between groups, but neonates with PVL had significantly more chronic diffuse capsular deciduitis (20.4%, 10.8%, P=.02) and capsular decidual plasma cells (8.4%, 2.4%, P=.02). Conditional logistic regression adjusting for birth weight and the presence of multiple gestation in the identification of PVL showed a significant increase for diffuse capsular deciduitis (P=.02) and capsular decidual plasma cells (P=.03).Periventricular leukomalacia has a significant but weak association with chronic diffuse capsular deciduitis and the presence of capsular decidual plasma cells, evidence of chronic infection but not histologic acute chorioamnionitis.II.Keywords
This publication has 24 references indexed in Scilit:
- The Prevalence of Chronic Deciduitis in Cases of Preterm Labor without Clinical ChorioamnionitisPediatric and Developmental Pathology, 2009
- Cerebral Palsy in Term Infants: A Clinicopathologic Analysis of 158 Medicolegal Case ReviewsPediatric and Developmental Pathology, 2008
- Histological Inflammatory Responses in the Placenta and Early Neonatal Brain InjuryPediatric and Developmental Pathology, 2008
- Placental Pathology: A Systematic Approach with Clinical CorrelationsPlacenta, 2008
- Placental Lesions as Predictors of Cerebral Palsy and Abnormal Neurocognitive Function at School Age in Extremely Low Birth Weight Infants (<1 kg)Pediatric and Developmental Pathology, 2007
- Chorioamnionitis and brain damage in the preterm newbornThe Journal of Maternal-Fetal & Neonatal Medicine, 2007
- Histologic placental lesions in women with recurrent preterm deliveryActa Obstetricia et Gynecologica Scandinavica, 2005
- Placental diagnostic criteria and clinical correlation – a workshop reportPlacenta, 2005
- Neonatal cerebral white matter injury in preterm infants is associated with culture positive infections and only rarely with metabolic acidosisAmerican Journal of Obstetrics and Gynecology, 2004
- Incidence and evolution of subependymal and intraventricular hemorrhage: A study of infants with birth weights less than 1,500 gmThe Journal of Pediatrics, 1978