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Enhancing the Retinopathy Of Prematurity Risk Profile Through Placental Evaluation of Maternal and Fetal Vascular Malperfusion.
El Emrani, Salma; Jansen, Esther J S; Goeman, Jelle J; Termote, Jacqueline U M; Lopriore, Enrico; Schalij-Delfos, Nicoline E; van der Meeren, Lotte E.
Afiliación
  • El Emrani S; Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands.
  • Jansen EJS; Neonatology, Willem-Alexander Children's Hospital, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands.
  • Goeman JJ; Neonatology, Wilhelmina Children's Hospital, Department of Women and Neonate, University Medical Center Utrecht, Utrecht, The Netherlands.
  • Termote JUM; Medical statistics, Department of Biomedical Data Science, Leiden University Medical Center, Leiden, The Netherlands.
  • Lopriore E; Neonatology, Wilhelmina Children's Hospital, Department of Women and Neonate, University Medical Center Utrecht, Utrecht, The Netherlands.
  • Schalij-Delfos NE; Neonatology, Willem-Alexander Children's Hospital, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands.
  • van der Meeren LE; Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands.
Invest Ophthalmol Vis Sci ; 65(11): 9, 2024 Sep 03.
Article en En | MEDLINE | ID: mdl-39230991
ABSTRACT

Purpose:

To determine the independent effect of uteroplacental malperfusion on the development of retinopathy of prematurity (ROP).

Methods:

This cohort study included 591 neonates with a gestational age (GA) ≤ 32 weeks or birthweight (BW) ≤ 1500 g. Clinical data was retrospectively collected and placentas were prospectively examined for maternal vascular malperfusion (e.g., abruption, infarct, distal villous hypoplasia, ischemia, and decidual necrosis) and fetal vascular malperfusion (e.g., thrombosis, fetal hypoxia, and hydrops parenchyma). The primary outcome was ROP. Secondary outcomes were GA, BW, small for gestational age (SGA), mechanical ventilation duration, postnatal corticosteroids, sepsis, and necrotizing enterocolitis.

Results:

Maternal vascular malperfusion was associated with higher GA, lower BW, and increased SGA rates, except placental abruption, which was associated with lower SGA rates. Fetal vascular malperfusion was associated with lower BW, increased SGA rates and lower duration of mechanical ventilation. Subgroup analysis of placentas without inflammation showed increased rates of distal villous hypoplasia (44% vs. 31%) and hydrops parenchyma (7% vs. 0%) in neonates with ROP. Multivariate regression analyses revealed three placenta factors to be independently associated with ROP distal villous hypoplasia (OR = 1.7; 95% CI, 1.0-3.0), severe acute histological chorioamnionitis (OR = 2.1; 95% CI, 1.1-3.9) and funisitis (OR = 1.8; 95% CI, 1.0-3.1).

Conclusions:

Placental evaluation of distal villous hypoplasia, severe acute chorioamnionitis and funisitis is a novel and valuable addition to the ROP risk profile. Evaluation of these placental risk factors shortly after birth can aid in identifying high-risk infants in an earlier stage than currently possible.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Placenta / Retinopatía de la Prematuridad / Edad Gestacional Límite: Adult / Female / Humans / Male / Newborn / Pregnancy Idioma: En Revista: Invest Ophthalmol Vis Sci Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Placenta / Retinopatía de la Prematuridad / Edad Gestacional Límite: Adult / Female / Humans / Male / Newborn / Pregnancy Idioma: En Revista: Invest Ophthalmol Vis Sci Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos