The relationship of general movements and early neurological development with placental histopathologies in late preterm infants

Late preterm infants are at risk of neonatal morbidities such as respiratory complications, hyperbilirubinemia, feeding difficulties, polycythemia, sepsis, short and long term neurodevelopmental problems. Abnormal placental histopathologies could play an important role not only on long term complications, but also on early stage neurological outcomes. Recognizing neurodevelopmental problems and providing early interventions are critical for risky late preterm infants. General Movement Assessment (GMA) and Hammersmith Infant Neurological Examinations (HINE) are used to determine these neurodevelopmental complications. Fifty one late preterm infants born in Başkent University Ankara Hospital between November 2021-December 2022 were enrolled in this study whose gestational age were 340/7-366/7 weeks. Gender difference was not important. Placentas were sent to Pathology Department during delivery by Obstetricians. In twin deliveries, placentas were assigned for each twin. Placental histopathologies were classified under 7 categories: 1-Inflammation, 2-Placentomegaly, 3-Placental hematomes and perivillous fibrin deposition, 4-Maternal uterine malperfusion, 5-Fetal vasculopathies, 6-Other, 7-Normal. Placental histopathology results were classified as "pathological" if any of the 6 pathological signs were observed. Fifty one late preterm infants were examined 3 times during the study which were done in the first week, first month and the third month of life. On the first examination newborn reflexes and GMs were examined. On the second and third examination which were done in the first and third month of life respectively; GMs and HINE were evaluated. Neurological status evaluated with GMs and HINE, neonatal morbidites and maternal comorbidities were compared between two groups according to the presence of placental histopathologies. No significant relation was present between neonatal morbidites, maternal risk factors and presence of placental histopathologies. There was a significant correlation between GDM and the absence of FMs on the third month GMs evaluation. HINE scores of SGA late preterm babies were found to be lower than AGA and LGA newborns. In addition, HINE scores were found to be lower if the GMs were abnormal. Early assessment of GMs and HINE are important and could be beneficial for defining short and long term neurodevelopmental problems. Placental histopathologies play an important role on the pathogenesis of neonatal morbidites and neurodevelopmental complications; and the evaluation of the placenta could help determining the possible risks and could guide the early diagnosis and intervention. The placental evaluation should be considered in each preterm delivery and short and long-term follow-up of preterm infants in risky groups in the postnatal period are important.