Hypoxic ischemic encephalopathy in newborns linked to placental and umbilical cord abnormalities

Objective: Birth asphyxia and hypoxic ischemic encephalopathy (HIE) of the newborn remain serious complications. We present a study investigating if placental or umbilical cord abnormalities in newborns at term are associated with HIE. Materials and methods: A prospective cohort study of the placent...

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Published in:	The journal of maternal-fetal & neonatal medicine Vol. 29; no. 5; pp. 721 - 726
Main Authors:	Nasiell, Josefine, Papadogiannakis, Nikos, Löf, Erika, Elofsson, Fanny, Hallberg, Boubou
Format:	Journal Article
Language:	English
Published:	England Taylor & Francis 03-03-2016
Subjects:	Adult Asphyxia Neonatorum - complications Asphyxia Neonatorum - epidemiology Case-Control Studies Female Humans Hypoxia-Ischemia, Brain - congenital Hypoxia-Ischemia, Brain - epidemiology Hypoxia-Ischemia, Brain - etiology Hypoxic ischemic encephalopathy Incidence Infant, Newborn Male Medicin och hälsovetenskap newborns placenta Placenta - abnormalities Pregnancy Pregnancy Complications - epidemiology Sweden - epidemiology Term Birth umbilical cord Umbilical Cord - abnormalities Vascular Malformations - complications Vascular Malformations - epidemiology velamentous/marginal insertion Sweden Hypoxic ischemic encephalopathy placenta newborns velamentous/marginal insertion umbilical cord
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Summary:	Objective: Birth asphyxia and hypoxic ischemic encephalopathy (HIE) of the newborn remain serious complications. We present a study investigating if placental or umbilical cord abnormalities in newborns at term are associated with HIE. Materials and methods: A prospective cohort study of the placenta and umbilical cord of infants treated with hypothermia (HT) due to hypoxic brain injury and follow-up at 12 months of age has been carried out. The study population included 41 infants treated for HT whose placentas were submitted for histopathological analysis. Main outcome measures were infant development at 12 months, classified as normal, cerebral palsy, or death. A healthy group of 100 infants without HIE and normal follow-up at 12 months of age were used as controls. Results: A velamentous or marginal umbilical cord insertion and histological abruption was associated with the risk of severe HIE, OR = 5.63, p = 0.006, respectively, OR = 20.3, p = 0.01 (multiple-logistic regression). Velamentous or marginal umbilical cord insertion was found in 39% among HIE cases compared to 7% in controls. Conclusions: Placental and umbilical cord abnormalities have a profound association with HIE. A prompt examination of the placentas of newborns suffering from asphyxia can provide important information on the pathogenesis behind the incident and contribute to make a better early prognosis.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1476-7058 1476-4954 1476-4954
DOI:	10.3109/14767058.2015.1015984