AUTHOR=Alongi Silvia , Lambicchi Laura , Moltrasio Francesca , Botto Valentina Alice , Bernasconi Davide Paolo , Cuttin Maria Serena , Paterlini Giuseppe , Malguzzi Silvia , Locatelli Anna 

TITLE=Placental pathology in perinatal asphyxia: a case–control study

JOURNAL=Frontiers in Clinical Diabetes and Healthcare

VOLUME=Volume 4 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/clinical-diabetes-and-healthcare/articles/10.3389/fcdhc.2023.1186362

DOI=10.3389/fcdhc.2023.1186362

ISSN=2673-6616

ABSTRACT=INTRODUCTION -Placentas of term infants with birth asphyxia are reported to have more lesions of maternal vascular malperfusion (MVM), fetal vascular malperfusion (FVM) and chorioamnionitis with fetal response (FIR). We compared the placental pathology of asphyxiated newborns, including those who developed hypoxic-ischemic encephalopathy (HIE), and non-asphyxiated controls.METHODS -We conducted a retrospective case-control study of placentas from neonates ≥ 35 weeks, birthweight ≥ 1800 g, and no malformations. Cases were asphyxiated newborns (defined as umbilical artery pH ≤ 7.0 or Base Excess ≤ -12 mMol, 10 min Apgar score ≤ 5, or need for resuscitation lasting >10 minutes) from a previous cohort, with (n=32) and without (n=173) diagnosis of HIE . Controls were non-asphyxiated newborns from physiological (n= 50) or at risk pregnancies (n= 68). Placentas were analyzed according to the Amsterdam Placental Workshop Group Consensus Statement 2014. RESULTS -Cases had higher prevalence of nulliparity, BMI>25, thick meconium, abnormal fetal heart monitoring and acute intrapartum events (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. Histological meconium-associated changes (MAC) were observed only in asphyxiated newborns (p= 0.039). DISCUSSION -Our results confirm the role of ante-and intra-partum risk factors for neonatal asphyxia and HIE. No association between neonatal asphyxia and placental lesions was found, except for MAC. The association of clinical and placental data is crucial to understand and possibly prevent perinatal asphyxia in subsequent pregnancies.