Association of perinatal sentinel events, placental pathology and cerebral MRI in neonates with hypoxic-ischemic encephalopathy receiving therapeutic hypothermia

Hellwig, Lia; Brada, Muriel; Held, Ulrike; Hagmann, Cornelia; Bode, P.; Frontzek, Karl; Frey, Bernhard; Brotschi, Barbara; Grass, Beate

doi:10.1038/s41372-022-01356-y

Cited by 8 publications

(4 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The authors stressed the need for further refinement of the classification and better educational efforts to fully implement the Amsterdam system. This would allow the results of different studies to be compared with greater reliability, possibly distinguishing between chronic and recent lesions ( 42 ).…”

Section: Discussionmentioning

confidence: 99%

Placental pathology in perinatal asphyxia: a case–control study

Alongi,

Lambicchi,

Moltrasio

et al. 2023

Front. Clin. Diabetes Healthc.

View full text Add to dashboard Cite

IntroductionPlacentas of term infants with birth asphyxia are reported to have more lesion such as maternal vascular malperfusion (MVM), fetal vascular malperfusion (FVM) and chorioamnionitis with fetal response (FIR) than those of term infants without birth asphyxia. We compared the placental pathology of asphyxiated newborns, including those who developed hypoxic-ischemic encephalopathy (HIE), with non-asphyxiated controls.MethodsWe conducted a retrospective case–control study of placentas from neonates with a gestational age ≥ 35 weeks, a birthweight ≥ 1,800 g, and no malformations. Cases were asphyxiated newborns (defined as those with an umbilical artery pH ≤ 7.0 or base excess ≤ −12 mMol, 10-minute Apgar score ≤ 5, or the need for resuscitation lasting >10 min) from a previous cohort, with (n=32) and without (n=173) diagnosis of HIE. Controls were non-asphyxiated newborns from low-risk l (n= 50) or high-risk (n= 68) pregnancies. Placentas were analyzed according to the Amsterdam Placental Workshop Group Consensus Statement 2014.ResultsCases had a higher prevalence of nulliparity, BMI>25, thick meconium, abnormal fetal heart monitoring, and acute intrapartum events than controls (p<0.001). MVM and FVM were more frequent among non-asphyxiated than asphyxiated newborns (p<0.001). There was no significant difference in inflammatory lesions or abnormal umbilical insertion site. Histologic meconium-associated changes (MAC) were observed in asphyxiated newborns only (p= 0.039).DiscussionOur results confirm the role of antepartum and intrapartum risk factors in neonatal asphyxia and HIE. No association between neonatal asphyxia and placental lesions was found, except for in the case of MAC. The association between clinical and placental data is crucial to understanding and possibly preventing perinatal asphyxia in subsequent pregnancies.

show abstract

Section: Discussionmentioning

confidence: 99%

Placental pathology in perinatal asphyxia: a case–control study

Alongi,

Lambicchi,

Moltrasio

et al. 2023

Front. Clin. Diabetes Healthc.

View full text Add to dashboard Cite

show abstract

“…Moreover, up to 60% of newborns who experience severe HIE die or develop profound disability [15]. Among those who experience severe HIE, 27% of children die by the age of 3 years old [16], and one-third of newborns with HIE, despite treatment, develop neurological symptoms of varying severity [17]. HIE severity is clinically evaluated using the Sarnat grading system, which is divided into grades I (mild), II (moderate), and III (severe) depending on HIE's manifestation and duration [18].…”

Section: Hypoxic-ischemic Encephalopathy As An Example Of Neonatal En...mentioning

confidence: 99%

Ultrasound Diagnosis and Near-Infrared Spectroscopy in the Study of Encephalopathy in Neonates Born under Asphyxia: Narrative Review

Lavrentev,

Petrova,

Serova

et al. 2024

Children

View full text Add to dashboard Cite

Brain injury resulting from adverse events during pregnancy and delivery is the leading cause of neonatal morbidity and disability. Surviving neonates often suffer long-term motor, sensory, and cognitive impairments. Birth asphyxia is among the most common causes of neonatal encephalopathy. The integration of ultrasound, including Doppler ultrasound, and near-infrared spectroscopy (NIRS) offers a promising approach to understanding the pathology and diagnosis of encephalopathy in this special patient population. Ultrasound diagnosis can be very helpful for the assessment of structural abnormalities associated with neonatal encephalopathy such as alterations in brain structures (intraventricular hemorrhage, infarcts, hydrocephalus, white matter injury) and evaluation of morphologic changes. Doppler sonography is the most valuable method as it provides information about blood flow patterns and outcome prediction. NIRS provides valuable insight into the functional aspects of brain activity by measuring tissue oxygenation and blood flow. The combination of ultrasonography and NIRS may produce complementary information on structural and functional aspects of the brain. This review summarizes the current state of research, discusses advantages and limitations, and explores future directions to improve applicability and efficacy.

show abstract

“…Neonatal encephalopathy (NE) remains a signi cant cause of neonatal morbidity and mortality and childhood disability across the world [1,2]. NE has many different aetiologies, including genetic, metabolic, infection, stroke and hypoxia ischaemia (HI).…”

Section: Introductionmentioning

confidence: 99%

A review of placental histology for infants with hypoxic ischemic encephalopathy compared with healthy controls: A retrospective case-control study

Fox,

Doyle,

Reynolds

et al. 2024

Preprint

View full text Add to dashboard Cite

Objective The role of the placenta in the development of hypoxic ischaemic encephalopathy (HIE) remains undefined. There is limited research comparing placental histology for infants with HIE and healthy controls. This is limiting our ability to understand its role in HIE. This study aimed to report the differences in placental histology between infants with HIE and healthy controls. Study Design A case-control study of (near-) term infants with moderate/severe HIE and healthy controls at a single tertiary NICU. Placental histology was reviewed by one perinatal histopathologist using consensus guidelines. Results Seventy-four cases and 98 controls were included. Cases had a higher incidence of pathology, including fetal vascular malperfusion, histological chorioamnionitis and delayed villous maturation. Conclusion This study demonstrates a higher incidence of placental pathology for infants born with HIE suggesting that the placenta is an important factor in the pathogenesis of HIE. Further research is required to delineate this relationship.

show abstract

Association of perinatal sentinel events, placental pathology and cerebral MRI in neonates with hypoxic-ischemic encephalopathy receiving therapeutic hypothermia

Cited by 8 publications

References 32 publications

Placental pathology in perinatal asphyxia: a case–control study

Placental pathology in perinatal asphyxia: a case–control study

Ultrasound Diagnosis and Near-Infrared Spectroscopy in the Study of Encephalopathy in Neonates Born under Asphyxia: Narrative Review

A review of placental histology for infants with hypoxic ischemic encephalopathy compared with healthy controls: A retrospective case-control study

Contact Info

Product

Resources

About