Association of placental histology and neonatal hematologic outcomes

Objective: The objective of the paper was to investigate how neonatal hematologic outcomes vary by major placental histopathology categories. Study design: Placental pathology reports from 5263 subjects were coded into individual placental lesions. Infant hematologic data (complete blood count parameters (n = 1945), transfusions, and phototherapy) were compared by placental pathologic phenotype. Results: Red blood cell transfusions were more likely with maternal vascular malperfusion (MVM; OR 9.4 [2.2, 40.8]) and chronic inflammation (1.7 [1.04, 2.7]). White blood cells were decreased with MVM (10.6 10³/μL vs 16.4) and elevated with acute inflammation (AI; 18.6 vs 11.9). Thrombocytopenia was associated with MVM (OR 3.7 [2.2, 5.1]) and fetal vascular malperfusion (FVM; OR 2.6 [1.5, 4.6]). Platelet transfusions were more likely with MVM (OR 8.3 [4.6, 15.0]) and FVM (OR 2.9 [1.4, 6.1]). Phototherapy was associated with MVM (OR 3.3 [2.7, 4.0]) and AI (OR 0.8 [0.6, 0.9]). Conclusions: Neonatal hematologic outcomes are associated with the in utero environment described by placental pathology.