Placental histopathological fi ndings and outcomes of babies born with a 5-minute Apgar score of less than seven in a regional hospital in Gqeberha, Eastern Cape

Abstract

Background: Perinatal asphyxia is a major cause of neonatal death in low- and middle-income countries and
is defi ned using the Apgar score, evidence of end organ damage, and neurological sequelae due to hypoxia.
Objectives: To describe placental histopathology in infants born with a 5-minute Apgar score of less than 7
and a gestational age of more than 37 weeks and correlate these fi ndings with pre-discharge outcome in the
same group.
Methods: This was a retrospective study conducted by reviewing clinical records of deliveries between 1
January 2016 and 30 September 2018. Clinical and demographic data as well as placental histopathology
fi ndings were collected from maternal and neonatal fi les.
Results: A total of 82 neonatal and 82 maternal records were included in the study. All infants required
resuscitation at birth and the majority of the infants with available data, 50/66 (76%) had a mildly abnormal
Thompson score. Evidence of chorioamnionitis was found in 38/82 (46%) patients and vascular insufficiency
in 34/82 (41%). Thirteen/82 (16%) of the placentas were normal. Twenty-fi ve (30%) infants had poor
outcomes of which 17 died. The most common placental abnormality found in infants with poor outcomes
was chorioamnionitis (32%). There was no signifi cant correlation between placental fi ndings and neonatal
outcomes (p = 0,842).
Conclusion: A signifi cant number of infants with a 5-minute Apgar score <7 had a good outcome at the
time of discharge. There was no signifi cant correlation between placental histopathology and death and/or
abnormal neurological fi ndings in the neonate in the current study.