新生儿缺氧缺血性脑病的胎盘表现。
Placental findings among newborns with hypoxic ischemic encephalopathy.
机构信息
Department of Pediatrics, Women & Infants Hospital of Rhode Island, Providence, RI, USA.
Department of Pathology, Women & Infants Hospital of Rhode Island, Providence, RI, USA.
出版信息
J Perinatol. 2019 Apr;39(4):563-570. doi: 10.1038/s41372-019-0334-9. Epub 2019 Feb 15.
OBJECTIVE
To determine if pre-specified placental abnormalities among newborns with hypoxic-ischemic encephalopathy (HIE) differ compared to newborns admitted to a NICU without encephalopathy.
STUDY DESIGN
Retrospective case-control study of newborns with HIE (2006-2014) and controls matched for birth year, gestational age, weight, and gender. One pathologist reviewed archived placental sections using pre-specified criteria.
RESULTS
Sixty-seven newborns had HIE, 46 had available placentas and were matched with 92 controls. HIE had more maternal vascular malperfusion (46% vs 25%, p = 0.02), fetal vascular malperfusion (13% vs 0%, p < 0.001), and clinical abruption (22% vs 4%, p = 0.001). Controls had more normal placentas (29% vs 7%, p = 0.002), and chorioamnionitis (30% vs 9%, p = 0.005). Pre-specified placental lesions occurred in 87% of HIE and 65% of controls (p = 0.008) and identified >90% of primary diagnoses.
CONCLUSIONS
Pre-specified placental lesions identified nearly all abnormalities in HIE and represented both acute and chronic processes.
目的
确定患有缺氧缺血性脑病（HIE）的新生儿与无脑病的新生儿相比，是否存在预先指定的胎盘异常。
研究设计
对 2006 年至 2014 年间患有 HIE 的新生儿（病例组）和按出生年份、胎龄、体重和性别匹配的对照组进行回顾性病例对照研究。一名病理学家使用预先指定的标准对存档的胎盘切片进行了评估。
结果
67 名新生儿患有 HIE，其中 46 名新生儿有可用的胎盘，并与 92 名对照组相匹配。HIE 组中更多出现母体血管异常灌注（46% vs 25%，p=0.02）、胎儿血管异常灌注（13% vs 0%，p<0.001）和临床胎盘早剥（22% vs 4%，p=0.001）。对照组中更多的胎盘正常（29% vs 7%，p=0.002），且绒毛膜羊膜炎更多见（30% vs 9%，p=0.005）。预先指定的胎盘病变在 HIE 组中发生率为 87%，在对照组中发生率为 65%（p=0.008），并可识别出 90%以上的主要诊断。
结论
预先指定的胎盘病变几乎可以识别出 HIE 中的所有异常，这些异常代表了急性和慢性的过程。
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