PhD Scientific Days 2025
Budapest, 7-9 July 2025
Poster Session III. - X: Conservative Medicine
Does placental pathology influence clinical presentation of HIE?
Name of the presenter
Zsáry Eszter
Institute/workplace of the presenter
Department of Neonatology, Pediatric Centre, Semmelweis University; Department of Obstetrics and Gynecology, Semmelweis University
Authors
Dr. Eszter Zsáry1,2, Adrienn Veress2, Dr. Enikő Mózes1, Dr. Dóra Hargitai3, Dr. Zsófia Kramer3, Dr. Beáta Hargitai1,3, Dr. Tamás Marton1,3, Prof. Dr. Miklós Szabó1,2
1: Department of Obstetrics and Gynecology, Semmelweis University
2: Department of Neonatology, Pediatric Centre, Semmelweis University
3: Department of Pathology, Forensic and Insurance Medicine, Semmelweis University
Text of the abstract
Introduction:
Perinatal complications are major contributors to the global burden of disease, accounting for a significant proportion of disability-adjusted life years (DALYs). In term neonates, perinatal asphyxia and hypoxic-ischemic encephalopathy (HIE) remain among the leading causes of mortality and morbidity. Unfavorable prognostic indicators include the presence of multi-organ failure (MOF). While various placental abnormalities have been observed in neonates with HIE, their clinical relevance and potential impact on prognosis are still not fully understood.
Aims:
To characterize the epidemiology of placental abnormalities in neonates with HIE and investigate potential associations between specific placental pathologies and clinical outcomes.
Method:
This retrospective cohort study included neonates treated for asphyxia and HIE at Semmelweis University between January 2019 and May 2024. Out of 333 cases, placental pathology reports were available in 84 (25%) cases.
Results:
Among the analyzed cases, 64% were male and 36% female, with a mean gestational age of 38.6 ±1.8 weeks (range: 33–42 weeks). MOF occurred in 63% of cases. Histopathological placental abnormalities included fetal vascular malperfusion (FVM) in 26%, chorioamnionitis (ACA/AFIS) in 19%, maternal vascular malperfusion (MVM) in 15%, chronic alloimmune villitis (VUE) in 12%, and delayed villous maturation (DVM) in 4%. No histological abnormalities were found in 32% of cases. MVM was less common in cases of HIE with MOF compared to those without MOF (8% vs 30%, p=0.01). MOF cases had a higher rate of normal placental histology (42% vs 13%, p=0.007).
Conclusion:
Increasing the availability of placental pathology data is essential for improved understanding of perinatal asphyxia. The frequent absence of placental abnormalities may reflect the acute onset of the condition. The lower occurrence of MVM in MOF cases could suggest that chronic hypoxia from MVM may precondition the fetus for subsequent hypoxic stress. Further studies are needed to validate this hypothesis.
Funding:
SUPPORTED BY THE EKÖP-2024-25 NEW NATIONAL EXCELLENCE PROGRAM OF THE MINISTRY FOR CULTURE AND INNOVATION FROM THE SOURCE OF THE NATIONAL RESEARCH, DEVELOPMENT AND INNOVATION FUND.