THE CORRELATION OF PRENATAL BRAIN-DAMAGE WITH PLACENTAL PATHOLOGY

Several epidemiological studies have emphasized that prenatal factors are the best predictors for cerebral palsy. Many placental pathologist s have anecdotally recognized an association between placental patholo gy and poor pregnancy outcome, including neurologic injury. This study was undertaken to determine if correlations exist between specific ty pes of placental pathology and prenatal brain injury. Ninety-eight sti llbirths and livebirths with <1 hour survival and complete placental a nd neuropathologic exams were reviewed. Most brain damage was in three categories: germinal matrix/intraventricular hemorrhage (GMH), white matter gliosis/necrosis (WMG/N), and neuronal necrosis. Statistical an alysis of contingency tables showed significant associations of WMN wi th placental chronic vascular changes (PCV), umbilical cord problems, old infarction/abruptio, and meconium staining of the placenta. Associ ations were found between neuronal necrosis and PCV, surface vessel th rombosis, and old infarction/abruptio. GMH was associated with funisit is, but no other factors. Fetuses with WMN or neuronal necrosis were o lder than fetuses with GMH or no neuropathology. It is likely that the se types of placental pathology can also be correlated with prenatal b rain injury in liveborn infants, and examination of the placenta may i ndicate which infants are at greater risk for neurologic injury.