Perinatal inflammation and placental programming of neonatal stroke

Chabrier, Stéphane; Sébire, Guillaume

doi:10.1111/dmcn.14375

Cited by 4 publications

(3 citation statements)

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“…This is similarly high to the rate of placental lesions in a cohort of patients we recently studied with congenital heart disease (78%) (39). Placental inflammatory conditions seem to play a prominent role in perinatal stroke pathophysiology (38), and our cohort has similar findings with 80% showing acute and/or chronic inflammation of the placenta. These inflammatory processes may contribute to formation of emboli of placental origin that reach the fetal cerebrovasculature through the PFO (38,40).…”

Section: Discussionsupporting

confidence: 83%

“…Placental inflammatory conditions seem to play a prominent role in perinatal stroke pathophysiology (38), and our cohort has similar findings with 80% showing acute and/or chronic inflammation of the placenta. These inflammatory processes may contribute to formation of emboli of placental origin that reach the fetal cerebrovasculature through the PFO (38,40). Further evidence supporting a placental origin of emboli are that an estimated 30% of neonatal stroke is multifocal, even in the absence of CHD and the recurrence of AIS postnatally is exceedingly rare (4).…”

Section: Discussionsupporting

confidence: 83%

“…Our understanding of the role of the placenta in perinatal AIS has evolved in recent years with new evidence emerging that there are high rates of multiple placental histopathologies in perinatal stroke, particularly AIS ( 37 , 38 ). Our cohort confirms those findings with 90% of stroke patients having at least one placental abnormality.…”

Section: Discussionmentioning

confidence: 99%

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Placental pathologic lesions associated with stroke in term neonates

et al. 2022

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ObjectiveTo determine the birth prevalence of perinatal stroke in term born infants at our high-volume delivery center and assess the frequency of both gross and histologic placental pathologies associated with perinatal stroke using the Amsterdam Placental Workshop Group Consensus Statement guidelines and definitions.Study DesignA single-center retrospective cohort study spanning 2010-2020.ResultsThere were 129,759 live births at Parkland Hospital during the study period and a total of 18 term born infants leading to a birth prevalence of 1 in 6,829 infants. Perinatal risk factors were found in all but one patient, and 74% presented with seizures. Pathologic placental examination was available in 56% of the cohort and only one patient had normal placental examination. Acute histologic chorioamnionitis was described in five placentas (50%) and an additional two had isolated umbilical and/or chorionic plate vasculitis with or without funisitis compared to a rate of 28% with acute inflammation in a Control group. Chronic inflammation in the form of villitis of unknown etiology was described in three of the acutely inflamed placentas and was high-grade in each of those while none of the placentas from our Control group showed evidence of any chronic lesion.ConclusionBoth acute and chronic placental inflammation are common in perinatal stroke; placental examination should be considered an essential component to the diagnostic workup.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 83%