The Association of Placental Abruption and Pediatric Neurological Outcome: A Systematic Review and Meta-Analysis
Placental histopathology provides insights, or “snapshots”, into relevant antenatal factors that could elevate the risk of perinatal brain injury. We present a systematic review and meta-analysis comparing frequencies of adverse neurological outcomes in infants born to women with placental abruption...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/1/205 |
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| author | Irina Oltean Ajay Rajaram Ken Tang James MacPherson Tadiwanashe Hondonga Aanchal Rishi Regan Toltesi Rachel Gowans Ashkan Jahangirnia Youssef Nasr Sarah L. Lawrence Dina El Demellawy |
| author_facet | Irina Oltean Ajay Rajaram Ken Tang James MacPherson Tadiwanashe Hondonga Aanchal Rishi Regan Toltesi Rachel Gowans Ashkan Jahangirnia Youssef Nasr Sarah L. Lawrence Dina El Demellawy |
| author_sort | Irina Oltean |
| collection | DOAJ |
| description | Placental histopathology provides insights, or “snapshots”, into relevant antenatal factors that could elevate the risk of perinatal brain injury. We present a systematic review and meta-analysis comparing frequencies of adverse neurological outcomes in infants born to women with placental abruption versus without abruption. Records were sourced from MEDLINE, Embase, and the CENTRAL Trials Registry from 1946 to December 2019. Studies followed the PRISMA guidelines and compared frequencies of neurodevelopmental morbidities in infants born to pregnant women with placental abruption (exposure) versus women without placental abruption (comparator). The primary endpoint was cerebral palsy. Periventricular and intraventricular (both severe and any grades of IVH) and any histopathological neuronal damage were the secondary endpoints. Study methodologic quality was assessed by the Ottawa–Newcastle scale. Estimated odds ratios (OR) and hazards ratio (HR) were derived according to study design. Data were meta-analyzed using a random effects model expressed as pooled effect sizes and 95% confidence intervals. We included eight observational studies in the review, including 1245 infants born to women with placental abruption. Results of the random effects meta-analysis show that the odds of infants born to pregnant women with placental abruption who experience cerebral palsy is higher than in infants born to pregnant women without placental abruption (OR 5.71 95% CI (1.17, 27.91); <i>I</i><sup>2</sup> = 84.0%). There is no statistical difference in the odds of infants born to pregnant women with placental abruption who experience severe IVH (grade 3+) (OR 1.20 95% CI (0.46, 3.11); <i>I</i><sup>2</sup> = 35.8%) and any grade of IVH (OR 1.20 95% CI (0.62, 2.32); <i>I</i><sup>2</sup> = 32.3%) vs. women without placental abruption. There is no statistically significant difference in the odds of infants born to pregnant women with placental abruption who experience PVL vs. pregnant women without placental abruption (OR 6.51 95% CI (0.94, 45.16); <i>I</i><sup>2</sup> = 0.0%). Despite our meta-analysis suggesting increased odds of cerebral palsy in infants born to pregnant women with placental abruption versus without abruption, this finding should be interpreted cautiously, given high heterogeneity and overall poor quality of the included studies. |
| first_indexed | 2024-03-11T09:56:36Z |
| format | Article |
| id | doaj.art-15bb60410b38440dbacfdfd38a0ec3f8 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T09:56:36Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-15bb60410b38440dbacfdfd38a0ec3f82023-11-16T15:42:53ZengMDPI AGJournal of Clinical Medicine2077-03832022-12-0112120510.3390/jcm12010205The Association of Placental Abruption and Pediatric Neurological Outcome: A Systematic Review and Meta-AnalysisIrina Oltean0Ajay Rajaram1Ken Tang2James MacPherson3Tadiwanashe Hondonga4Aanchal Rishi5Regan Toltesi6Rachel Gowans7Ashkan Jahangirnia8Youssef Nasr9Sarah L. Lawrence10Dina El Demellawy11Department of Surgery & Pathology, Children’s Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, CanadaDepartment of Pathology, McGill University, Montreal, QC H4A 3J1, CanadaDepartment of Surgery & Pathology, Children’s Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, CanadaDepartment of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, ON K1H 8M5, CanadaDepartment of Health Sciences, Carleton University, Ottawa, ON K1S 5B6, CanadaSchulich School of Medicine & Dentistry, Western University, London, ON N6A 5C1, CanadaFaculty of Science, Engineering and Architecture, Laurentian University, Sudbury, ON P3E 2C6, CanadaFaculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, CanadaFaculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, CanadaDepartment of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, ON K1H 8M5, CanadaFaculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, CanadaFaculty of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, CanadaPlacental histopathology provides insights, or “snapshots”, into relevant antenatal factors that could elevate the risk of perinatal brain injury. We present a systematic review and meta-analysis comparing frequencies of adverse neurological outcomes in infants born to women with placental abruption versus without abruption. Records were sourced from MEDLINE, Embase, and the CENTRAL Trials Registry from 1946 to December 2019. Studies followed the PRISMA guidelines and compared frequencies of neurodevelopmental morbidities in infants born to pregnant women with placental abruption (exposure) versus women without placental abruption (comparator). The primary endpoint was cerebral palsy. Periventricular and intraventricular (both severe and any grades of IVH) and any histopathological neuronal damage were the secondary endpoints. Study methodologic quality was assessed by the Ottawa–Newcastle scale. Estimated odds ratios (OR) and hazards ratio (HR) were derived according to study design. Data were meta-analyzed using a random effects model expressed as pooled effect sizes and 95% confidence intervals. We included eight observational studies in the review, including 1245 infants born to women with placental abruption. Results of the random effects meta-analysis show that the odds of infants born to pregnant women with placental abruption who experience cerebral palsy is higher than in infants born to pregnant women without placental abruption (OR 5.71 95% CI (1.17, 27.91); <i>I</i><sup>2</sup> = 84.0%). There is no statistical difference in the odds of infants born to pregnant women with placental abruption who experience severe IVH (grade 3+) (OR 1.20 95% CI (0.46, 3.11); <i>I</i><sup>2</sup> = 35.8%) and any grade of IVH (OR 1.20 95% CI (0.62, 2.32); <i>I</i><sup>2</sup> = 32.3%) vs. women without placental abruption. There is no statistically significant difference in the odds of infants born to pregnant women with placental abruption who experience PVL vs. pregnant women without placental abruption (OR 6.51 95% CI (0.94, 45.16); <i>I</i><sup>2</sup> = 0.0%). Despite our meta-analysis suggesting increased odds of cerebral palsy in infants born to pregnant women with placental abruption versus without abruption, this finding should be interpreted cautiously, given high heterogeneity and overall poor quality of the included studies.https://www.mdpi.com/2077-0383/12/1/205infantchildabruptio placentaepregnant womencerebral palsymorbidity |
| spellingShingle | Irina Oltean Ajay Rajaram Ken Tang James MacPherson Tadiwanashe Hondonga Aanchal Rishi Regan Toltesi Rachel Gowans Ashkan Jahangirnia Youssef Nasr Sarah L. Lawrence Dina El Demellawy The Association of Placental Abruption and Pediatric Neurological Outcome: A Systematic Review and Meta-Analysis Journal of Clinical Medicine infant child abruptio placentae pregnant women cerebral palsy morbidity |
| title | The Association of Placental Abruption and Pediatric Neurological Outcome: A Systematic Review and Meta-Analysis |
| title_full | The Association of Placental Abruption and Pediatric Neurological Outcome: A Systematic Review and Meta-Analysis |
| title_fullStr | The Association of Placental Abruption and Pediatric Neurological Outcome: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | The Association of Placental Abruption and Pediatric Neurological Outcome: A Systematic Review and Meta-Analysis |
| title_short | The Association of Placental Abruption and Pediatric Neurological Outcome: A Systematic Review and Meta-Analysis |
| title_sort | association of placental abruption and pediatric neurological outcome a systematic review and meta analysis |
| topic | infant child abruptio placentae pregnant women cerebral palsy morbidity |
| url | https://www.mdpi.com/2077-0383/12/1/205 |
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