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

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

doi:10.1038/s41372-022-01356-y

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

J Perinatol. 2022 Jul;42(7):885-891. doi: 10.1038/s41372-022-01356-y. Epub 2022 Feb 28.

Authors

Lia Hellwig^{1

2}, Muriel Brada³, Ulrike Held⁴, Cornelia Hagmann^{1

2

5}, Peter Bode^{2

3}, Karl Frontzek^{2

6}, Bernhard Frey¹, Barbara Brotschi^{1

2

5}, Beate Grass^{7

8

9}

Affiliations

¹ Division of Neonatology and Pediatric Intensive Care, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland.
² University of Zurich, Raemistrasse 71, 8006, Zurich, Switzerland.
³ Department of Pathology and Molecular Pathology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland.
⁴ Epidemiology, Biostatistics and Prevention Institute, Department of Biostatistics, University of Zurich, Hirschengraben 84, 8001, Zurich, Switzerland.
⁵ Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland.
⁶ Institute of Neuropathology, University Hospital Zurich, Schmelzbergstrasse 12, 8091, Zurich, Switzerland.
⁷ Division of Neonatology and Pediatric Intensive Care, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland. beate.grass@kispi.uzh.ch.
⁸ University of Zurich, Raemistrasse 71, 8006, Zurich, Switzerland. beate.grass@kispi.uzh.ch.
⁹ Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland. beate.grass@kispi.uzh.ch.

Abstract

Objective: Placental pathology might provide information on the etiology of hypoxic-ischemic encephalopathy (HIE). To evaluate the association of perinatal sentinel events (PSE), placental pathology and cerebral MRI in cooled neonates with moderate/severe HIE.

Study design: Retrospective analysis of 52 neonates with HIE registered in the Swiss National Asphyxia and Cooling Register 2011-2019. PSE and Non-PSE groups were tested for association with placental pathology. Placental pathology categories were correlated with MRI scores.

Results: In total, 14/52 neonates (27%) had a PSE, 38 neonates (73%) did not have a PSE. There was no evidence for an association of occurrence of PSE and placental pathologies (p = 0.364). Neonates with high MRI scores tended to have more often chronic pathologies in their placentas than acute pathologies or normal placentas (p = 0.067).

Conclusion: Independent of the occurrence of PSE, chronic placental pathologies might be associated with more severe brain injury and needs further study.

MeSH terms

Female
Humans
Hypothermia, Induced* / adverse effects
Hypoxia-Ischemia, Brain* / complications
Hypoxia-Ischemia, Brain* / diagnostic imaging
Hypoxia-Ischemia, Brain* / therapy
Infant, Newborn
Magnetic Resonance Imaging
Placenta / diagnostic imaging
Placenta / pathology
Pregnancy
Retrospective Studies