Placental pathology and long-term neurodevelopment of very preterm infants - 24/05/12

Doi : 10.1016/j.ajog.2012.03.024

Elvira O.G. van Vliet, BSc ^a, Jorrit F. de Kieviet, MSc ^c, J. Patrick van der Voorn, MD, PhD ^b, Jasper V. Been, MD, MPH, PhD ^d, Jaap Oosterlaan, PhD ^c, Ruurd M. van Elburg, MD, PhD ^a
^a Division of Neonatology, Department of Pediatrics, VU University Medical Center, Amsterdam, The Netherlands
^b Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands
^c Department of Clinical Neuropsychology, VU University, Amsterdam, The Netherlands
^d Department of Pediatrics, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Center, Maastricht, The Netherlands

Résumé

Objective

The objective of the study was to compare neonatal morbidity and long-term neurodevelopmental outcome between very preterm infants with placental underperfusion and very preterm infants with histological chorioamnionitis.

Study Design

We measured the mental and motor development at age 2 and 7 years in 51 very preterm infants with placental underperfusion and 21 very preterm infants with histological chorioamnionitis.

Results

At 2 years, very preterm infants with placental underperfusion had poorer mental development than very preterm infants with histological chorioamnionitis (mean [SD] 90.8 [18.3] vs 104.1 [17.2], adjusted d = 1.12, P = .001). Motor development was not different between both groups (92.8 [17.2] vs 96.8 [8.7], adjusted d = 0.52, P = .12). At 7 years, large, although nonsignificant, effects were found for better mental and motor development and fewer behavioral problems in infants with histological chorioamnionitis.

Conclusion

Placental pathology contributes to variance in mental development at 2 years and should be taken into account when evaluating neurodevelopmental outcome of very preterm infants.

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Key words : follow-up studies, infant, neonatology, neurodevelopment, placenta diseases, premature

Plan

Materials and Methods

Sample

Placental histological examination

Perinatal characteristics

Mortality and neonatal morbidity

Short-term and long-term neurodevelopmental outcome

Statistical analysis

Results

Subjects

Perinatal characteristics

Mortality and neonatal morbidity

Neurodevelopmental outcome at age 2 years

Neurodevelopmental outcome at age 7 years

Comment

	J.V.B. is supported by a Maastricht University Kootstra Talent Fellowship.
	The authors report no conflict of interest.
	Reprints not available from the authors.
	Cite this article as: van Vliet EOG, de Kieviet JF, van der Voorn JP, et al. Placental pathology and long-term neurodevelopment of very preterm infants. Am J Oster Gynecol 2012;206:489.e1-7.

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Vol 206 - N° 6

P. 489.e1-489.e7 - juin 2012 Retour au numéro

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Placental pathology and long-term neurodevelopment of very preterm infants - 24/05/12

Résumé

Objective

Study Design

Results

Conclusion

Plan

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