Impact of placental histopathology and maternal risk factors on neonatal morbidity in late preterm infants

Background: Maternal and placental risk factors are critical determinants of neonatal outcomes in preterm infants. This study aims to evaluate the impact of placental histopathological findings and maternal risk factors on neonatal morbidity and mortality among late preterm infants. Methods: This prospective study was conducted between January and July 2018 at Başkent University Faculty of Medicine. A total of 62 late preterm infants, born via cesarean section between 34^0⁄7 and 36^6⁄7 weeks of gestation, were included. Neonatal morbidities were assessed in relation to placental histopathological features and maternal risk factors. Placental examinations included both gross and microscopic evaluations, focusing on maternal vascular malperfusion, chronic inflammation, placentomegaly, placental hematomas, and fetal obliterative vasculopathy. Results: Placental histopathological abnormalities and maternal risk factors were significantly associated with adverse neonatal outcomes. Maternal vascular malperfusion correlated with an increased risk of hyperbilirubinemia and intracranial hemorrhage. Chronic placental inflammation was linked to polycythemia and feeding intolerance. Placentomegaly was associated with early-onset neonatal sepsis and feeding difficulties. Additionally, maternal conditions such as preeclampsia, thrombophilia, oligohydramnios, and maternal infections were found to influence neonatal morbidity. Conclusions: Placental histopathological findings particularly maternal malperfusion, chronic inflammation, and placentomegaly appear to contribute significantly to neonatal morbidity in late preterm infants. The combined assessment of placental pathology and maternal risk factors may enhance early prediction of neonatal complications and guide postnatal clinical management.