Objective: To study associations between placental histopathology and stillbirth as well as neonatal outcome in a population born extremely preterm.
Design: Prospective cohort study.
Setting: Stockholm, Sweden.
Population: 167 infants born <27 gestational weeks during 2004-2007.
Methods: One senior perinatal pathologist, blinded to outcome data, evaluated all placental slides.
Main outcome measures: Intrauterine fetal death, small-for-gestational age, major neonatal morbidity (intraventricular hemorrhage ≥grade 3, retinopathy of prematurity ≥grade 3, necrotizing enterocolitis, cystic periventricular leukomalacia or severe bronchopulmonary dysplasia) and neonatal mortality. Additional outcome variables were Apgar score at 5 min, sepsis, and treated patent ductus arteriosus.
Results: Accelerated villous maturation was associated with a decreased risk for Apgar score <7 at 5 min (p = 0.041). Fetal thrombosis and low placental weight were associated with an increased risk for both intrauterine fetal death (p < 0.001 and p = 0.011, respectively) and small-for-gestational age (p < 0.001 and p < 0.001, respectively).
Conclusion: Placental histology may have prognostic value as it appears to be associated with intrauterine fetal death, as well as with being small-for-gestational age and assignment of a low Apgar score at birth.
Keywords: Histopathology; placental weight; prematurity; thrombosis; villous maturation.
© 2015 Nordic Federation of Societies of Obstetrics and Gynecology.