P2.G137: Placental Pathology and Neonatal Outcomes Associated with Lenticulostriate Vasculopathy in Extremely Preterm Infants: A Case Control Study

Background: Recent small-scale studies have highlighted an association between lenticulostriate vasculopathy (LSV) and bronchopulmonary dysplasia (BPD), as well as necrotizing enterocolitis (NEC) in extremely preterm (EP) infants. However, the factors preceding the development of LSV remain unclear. Placental pathology, an underutilized tool, can provide valuable insights into the prenatal environment leading up to LSV. Our study aims to identify placental pathologic abnormalities and neonatal outcomes associated with LSV in EP infants. We hypothesized that EP infants with LSV would exhibit a higher prevalence of placental abnormalities and adverse neonatal outcomes.

Methods: In this retrospective, single-center study, we analyzed cranial ultrasounds of EP infants born between January 2017 and December 2022. Neonates with confirmed LSV (cases) were compared with two gestational age—and sex-matched controls. Placental pathological abnormalities were compared between the groups. We also compared neonatal in-hospital morbidity and mortality between the two groups.

Results: The study included 63 LSV cases and 126 controls without LSV. Baseline characteristics and neonatal morbidity and mortality did not differ between the groups. Placental evaluations were conducted in 89.7% of the LSV group and 88.9% of the control group. Notably, the LSV group exhibited a higher prevalence of large-for-gestational-age (LGA) placentas (8.9% vs. 0.9%, p < 0.01) compared to the control group. Additionally, the LSV group had an increased prevalence of fetal vascular malperfusion (64.5% vs. 47.3%, p = 0.03) and acute placental changes (39.3% vs. 22.3%, p = 0.02) relative to the control group.

Conclusion: Our study observed a higher prevalence of placental abnormalities in the LSV group. However, interestingly, we did not find a corresponding increase in adverse neonatal outcomes. Further study on the effect of LSV on long-term outcomes is ongoing.