TY - JOUR
T1 - Placental origins of neonatal diseases
T2 - toward a precision medicine approach
AU - Mir, Imran N.
AU - Leon, Rachel
AU - Chalak, Lina F.
N1 - Funding Information:
This work was supported by NIH Grant 5R01NS102617-03 awarded to L.F.C.
Publisher Copyright:
© 2020, International Pediatric Research Foundation, Inc.
PY - 2021/1
Y1 - 2021/1
N2 - Abstract: The placenta is the single most reliable source for precise information on intrauterine environment, as well as maternal and fetal health. It mediates the physiology of two distinct yet highly interconnected individuals. The pathology that develops in the placenta, and the adaptations the placenta undergoes to mitigate this pathology, may influence the later life health of the mother and baby. Pathological placental examination provides a unique opportunity to explore and understand the intrauterine environment, as well as providing a record of events that may be associated with adverse pregnancy outcomes. A number of placental lesions have been described in association with various neonatal morbidities. The purpose of this review is to summarize the evidence for the association of placental pathologic lesions with neurodevelopmental outcomes infants with specific neonatal morbidities, including (1) neonatal encephalopathy, (2) bronchopulmonary dysplasia, (3) congenital heart diseases, and (4) autism spectrum disorders. For each of these disease processes, we will also propose specific research priorities in future studies. We conclude with a hospital-specific protocol for triaging which placentas should receive histological evaluation as a fundamental first step for the field of neuroplacentology to guide precision-based therapeutic approaches in the affected newborns. Impact: The purpose of this review is to summarize the evidence for placental origins of neonatal diseases.We propose specific research priorities in the field of neuroplacentology in future studies.We also present a targeted hospital-based approach for triaging which placentas should receive histological evaluation.
AB - Abstract: The placenta is the single most reliable source for precise information on intrauterine environment, as well as maternal and fetal health. It mediates the physiology of two distinct yet highly interconnected individuals. The pathology that develops in the placenta, and the adaptations the placenta undergoes to mitigate this pathology, may influence the later life health of the mother and baby. Pathological placental examination provides a unique opportunity to explore and understand the intrauterine environment, as well as providing a record of events that may be associated with adverse pregnancy outcomes. A number of placental lesions have been described in association with various neonatal morbidities. The purpose of this review is to summarize the evidence for the association of placental pathologic lesions with neurodevelopmental outcomes infants with specific neonatal morbidities, including (1) neonatal encephalopathy, (2) bronchopulmonary dysplasia, (3) congenital heart diseases, and (4) autism spectrum disorders. For each of these disease processes, we will also propose specific research priorities in future studies. We conclude with a hospital-specific protocol for triaging which placentas should receive histological evaluation as a fundamental first step for the field of neuroplacentology to guide precision-based therapeutic approaches in the affected newborns. Impact: The purpose of this review is to summarize the evidence for placental origins of neonatal diseases.We propose specific research priorities in the field of neuroplacentology in future studies.We also present a targeted hospital-based approach for triaging which placentas should receive histological evaluation.
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U2 - 10.1038/s41390-020-01293-6
DO - 10.1038/s41390-020-01293-6
M3 - Review article
C2 - 33288874
AN - SCOPUS:85097234381
SN - 0031-3998
VL - 89
SP - 377
EP - 383
JO - Pediatric Research
JF - Pediatric Research
IS - 2
ER -