Placental pathology and long-term neurodevelopment of very preterm infants

Vliet, Elvira O.G. van; Kieviet, Jorrit F. de; Voorn, J. Patrick van der; Been, Jasper V; Oosterlaan, Jaap; Elburg, Ruurd M. van

doi:10.1016/j.ajog.2012.03.024

Cited by 68 publications

(51 citation statements)

References 36 publications

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“…Despite remarkable differences in the severity of the fetal disease, early- and late-onset FGRs are both associated with poor long-term outcome from neurodevelopmental, cardiovascular and metabolic standpoints [21,22,23,32,33]. This supports the notion that regardless of the severity, chronic exposure to adverse intrauterine environment is critical to determine adverse fetal programming.…”

Section: Pathophysiological and Clinical Differences In Early-severe supporting

confidence: 65%

Update on the Diagnosis and Classification of Fetal Growth Restriction and Proposal of a Stage-Based Management Protocol

Figueras

Gratacós²

2014

Fetal Diagn Ther

597

672

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Small fetuses are defined as those with an ultrasound estimated weight below a threshold, most commonly the 10th centile. The first clinically relevant step is the distinction of ‘true' fetal growth restriction (FGR), associated with signs of abnormal fetoplacental function and poorer perinatal outcome, from constitutional small-for-gestational age, with a near-normal perinatal outcome. Nowadays such a distinction should not be based solely on umbilical artery Doppler, since this index detects only early-onset severe forms. FGR should be diagnosed in the presence of any of the factors associated with a poorer perinatal outcome, including Doppler cerebroplacental ratio, uterine artery Doppler, a growth centile below the 3rd centile, and, possibly in the near future, maternal angiogenic factors. Once the diagnosis is established, differentiating into early- and late-onset FGR is useful mainly for research purposes, because it distinguishes two clear phenotypes with differences in severity, association with preeclampsia, and the natural history of fetal deterioration. As a second clinically relevant step, management of FGR and the decision to deliver aims at an optimal balance between minimizing fetal injury or death versus the risks of iatrogenic preterm delivery. We propose a protocol that integrates current evidence to classify stages of fetal deterioration and establishes follow-up intervals and optimal delivery timings, which may facilitate decisions and reduce practice variability in this complex clinical condition.

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Section: Pathophysiological and Clinical Differences In Early-severe supporting

confidence: 65%

Update on the Diagnosis and Classification of Fetal Growth Restriction and Proposal of a Stage-Based Management Protocol

Figueras

Gratacós²

2014

Fetal Diagn Ther

597

672

View full text Add to dashboard Cite

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“…They also found fetal thrombotic vasculopathy to be associated with cerebral palsy. Obstructive umbilical cord abnormalities and placental infarction have been identified in cases of cerebral palsy of varying severity and presentations [5,8,[17][18][19]. To our knowledge, the association between isolated vascular compromise, as denoted by a combination of vasculopathy-coagulopathy, and IVH in ELBW infants was not reported before.…”

Section: Discussioncontrasting

confidence: 51%

Isolated Placental Inflammation and Vasculopathy: Clinical Implications in the Extremely Low Birth Weight Infants

Verma

Zhao

Kaplan

2016

Fetal and Pediatric Pathology

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“…In 19 of 27 studies, the patient characteristics were clearly differentiated between the CA and non-CA groups. In 15 out of these 19 studies, there was a significantly higher GA at birth among the non-CA group compared to the CA group [21,27,28,36,41,43,45,56,57,58,60,62,63,64,65]. Only 8 studies showed no difference among the groups in terms of GA [42,43,47,50,52,58,61,66].…”

Section: Methodsmentioning

confidence: 99%

“…The clinical profile of the infants and the methodological characteristics of the studies have been summarized in online supplementary appendix A (see www.karger.com/doi/10.1159/000357556 for all online suppl. material) [36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69]. …”

Section: Methodsmentioning

confidence: 99%

Chorioamnionitis as a Risk Factor for Retinopathy of Prematurity: A Systematic Review and Meta-Analysis

Mitra

Aune²,

Speer³

et al. 2014

Neonatology

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Background: The role of chorioamnionitis (CA) in the development of retinopathy of prematurity (ROP) has not been well established. Objective: To conduct a systematic review and meta-analysis of the association between CA and ROP in preterm infants. Data Sources: The authors searched MEDLINE, Embase, CINAHL, Cochrane Central Register of Controlled Trials and PubMed, reviewed reference lists of relevant articles, abstracts and conference proceedings (Society for Pediatric Research, European Society for Paediatric Research 1990-2012), sought results of unpublished trials, and contacted the primary authors of relevant studies. Study Selection: Studies were included if they had a comparison group, examined preterm infants, and reported primary data that could be used to measure the association between exposure to CA and the development of ROP. Data Extraction: Two reviewers independently screened the search results, applied inclusion criteria and assessed methodological quality using the Newcastle-Ottawa Scale. One reviewer extracted data and a second reviewer checked data extraction. Summary relative risks (RRs) were calculated using a random effects model. Data Synthesis: We identified 1,249 potentially relevant studies from the electronic databases. Twenty-seven studies involving 10,590 preterm neonates with 2,562 cases of ROP were included. Taking into account all included studies without adjusting for gestational age (GA), CA was significantly associated with ROP (any stage) [summary RR 1.33 (95% CI 1.14-1.55, I² = 77%, p_{heterogeneity} < 0.0001)], and a borderline significant association was observed for severe ROP (stage ≥3) [summary RR 1.27 (95% CI 0.99-1.63, I² = 74%, p_{heterogeneity} < 0.0001)]. There was no publication bias with Begg's test. However, subgroup analysis of studies adjusting for GA showed no significant association on CA with ROP [summary RR 0.98 (95% CI 0.77-1.26, I² = 0%, p_{heterogeneity} = 0.89)]. Conclusion: Unadjusted analyses showed that CA was significantly associated with ROP (any stage) as well as with severe ROP (stage ≥ 3). However, the association disappeared on analysis of studies adjusting for GA. Hence, CA cannot be definitively considered as a risk factor for ROP, and further studies should adjust for potential confounding factors and report results by stage to clarify the association with severe ROP.

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Placental pathology and long-term neurodevelopment of very preterm infants

Cited by 68 publications

References 36 publications

Update on the Diagnosis and Classification of Fetal Growth Restriction and Proposal of a Stage-Based Management Protocol

Update on the Diagnosis and Classification of Fetal Growth Restriction and Proposal of a Stage-Based Management Protocol

Isolated Placental Inflammation and Vasculopathy: Clinical Implications in the Extremely Low Birth Weight Infants

Chorioamnionitis as a Risk Factor for Retinopathy of Prematurity: A Systematic Review and Meta-Analysis

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