Placental pathology and long-term neurodevelopment of very preterm infants

• DOI: 10.1016/j.ajog.2012.03.024
• Publication Date: 2012-03-29T06:44:30Z
• Authors: Elvira O.G. van V...; Jorrit F. de Kieviet; J. Patrick van de...; Jasper V. Been; Jaap Oosterlaan; Ruurd M. van Elburg
• Keywords: Male; Child Behavior Disorders; Infant, Premature, Diseases; neonatology; premature; 03 medical and health sciences; Child Development; 0302 clinical medicine; SDG 3 - Good Health and Well-being; Pregnancy; Obstetrics and Gynaecology; Humans; Child; Psychological Tests; neurodevelopment; placenta diseases; Infant, Newborn; Placental Insufficiency; infant; follow-up studies; Chorioamnionitis; Logistic Models; Child, Preschool; Prenatal Exposure Delayed Effects; Female; Infant, Premature; Psychomotor Performance; Follow-Up Studies

The objective of the study was to compare neonatal morbidity and long-term neurodevelopmental outcome between very preterm infants with placental underperfusion and very preterm infants with histological chorioamnionitis.We measured the mental and motor development at age 2 and 7 years in 51 very preterm infants with placental underperfusion and 21 very preterm infants with histological chorioamnionitis.At 2 years, very preterm infants with placental underperfusion had poorer mental development than very preterm infants with histological chorioamnionitis (mean [SD] 90.8 [18.3] vs 104.1 [17.2], adjusted d = 1.12, P = .001). Motor development was not different between both groups (92.8 [17.2] vs 96.8 [8.7], adjusted d = 0.52, P = .12). At 7 years, large, although nonsignificant, effects were found for better mental and motor development and fewer behavioral problems in infants with histological chorioamnionitis.Placental pathology contributes to variance in mental development at 2 years and should be taken into account when evaluating neurodevelopmental outcome of very preterm infants.