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神经胎盘学在胎儿生长受限和早产儿中的研究现状:文献综述。

What is known about neuroplacentology in fetal growth restriction and in preterm infants: A narrative review of literature.

机构信息

Department of Obstetrics and Gynecology, Fondazione Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia, Italy.

Department of Obstetrics and Gynecology, University of Pavia, Pavia, Italy.

出版信息

Front Endocrinol (Lausanne). 2022 Aug 19;13:936171. doi: 10.3389/fendo.2022.936171. eCollection 2022.

Abstract

The placenta plays a fundamental role during pregnancy for fetal growth and development. A suboptimal placental function may result in severe consequences during the infant's first years of life. In recent years, a new field known as neuroplacentology has emerged and it focuses on the role of the placenta in fetal and neonatal brain development. Because of the limited data, our aim was to provide a narrative review of the most recent knowledge about the relation between placental lesions and fetal and newborn neurological development. Papers published online from 2000 until February 2022 were taken into consideration and particular attention was given to articles in which placental lesions were related to neonatal morbidity and short-term and long-term neurological outcome. Most research regarding the role of placental lesions in neurodevelopment has been conducted on fetal growth restriction and preterm infants. Principal neurological outcomes investigated were periventricular leukomalacia, intraventricular hemorrhages, neonatal encephalopathy and autism spectrum disorder. No consequences in motor development were found. All the considered studies agree about the crucial role played by placenta in fetal and neonatal neurological development and outcome. However, the causal mechanisms remain largely unknown. Knowledge on the pathophysiological mechanisms and on placenta-related risks for neurological problems may provide clues for early interventions aiming to improve neurological outcomes, especially among pediatricians and child psychiatrists.

摘要

胎盘在胎儿生长和发育过程中起着至关重要的作用。胎盘功能不佳可能会导致婴儿生命的头几年出现严重后果。近年来,一个名为神经胎盘学的新领域出现了,它专注于胎盘在胎儿和新生儿大脑发育中的作用。由于数据有限,我们的目的是提供一篇关于胎盘病变与胎儿和新生儿神经发育之间关系的最新知识的叙述性综述。考虑了 2000 年至 2022 年 2 月在线发表的论文,并特别关注了胎盘病变与新生儿发病率以及短期和长期神经结局相关的文章。关于胎盘病变在神经发育中的作用的大多数研究都是针对胎儿生长受限和早产儿进行的。研究的主要神经结局包括脑室周围白质软化、脑室内出血、新生儿脑病和自闭症谱系障碍。未发现运动发育方面的不良后果。所有考虑到的研究都同意胎盘在胎儿和新生儿神经发育和结局中起着至关重要的作用。然而,因果机制在很大程度上仍然未知。对与神经问题相关的病理生理机制和胎盘相关风险的了解,可能为旨在改善神经结局的早期干预措施提供线索,特别是在儿科医生和儿童精神科医生中。

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