Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Comment
  • Published:

Systematic, prospective collection of placental specimens is crucial for future studies on the maternal-placental-fetal triad in neonatal encephalopathy

Pediatric Research (2023)Cite this article

We thank Fox et al.1 for their thoughtful commentary on our recently published study in Pediatric Research.2 As stated, research on placental pathology and its influence on neonatal neurodevelopmental outcomes is sparse. We heartily agree that the relationship of the placenta to neonatal encephalopathy (NE) needs to be an emphasis of current and future research. Our study aimed to bolster the literature investigating this relationship, though it also highlights the need for larger, systematic, prospective collection of maternal, placental, and neonatal data from both neonates with NE and healthy control subjects to progress beyond small associational studies and more confidently infer causal placental contributions.

We undertook this study in part to explore what placental information could be readily retrieved at a typical tertiary care center and found that placental specimens are preserved and banked with limited frequency and consistency. We suspect this is likely the case at many institutions. Without a standardized protocol for systematically and prospectively banking placental specimens, particularly from healthy pregnancies for use as controls, our pool of maternal-placental-fetal triads was limited, in turn limiting the research questions we could investigate with this sample.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Fox, A., Doyle, E. & Hayes, B. Understanding the role of the placenta in neonatal encephalopathy and outcome. Pediatr. Res. (2023). https://doi.org/10.1038/s41390-023-02921-7

  2. Stone, A. C. et al. The association of placental pathology and neurodevelopmental outcomes in patients with neonatal encephalopathy. Pediatr. Res. (2023). https://doi.org/10.1038/s41390-023-02737-5

  3. Mir, I. N. et al. Placental pathology is associated with severity of neonatal encephalopathy and adverse developmental outcomes following hypothermia. Am. J. Obstet. Gynecol. 213, 849.e841–847 (2015).

    Article  Google Scholar 

  4. Nasiell, J., Papadogiannakis, N., Lof, E., Elofsson, F. & Hallberg, B. Hypoxic ischemic encephalopathy in newborns linked to placental and umbilical cord abnormalities. J. Matern. Fetal Neonatal. Med. 29, 721–726 (2016).

    Article  PubMed  CAS  Google Scholar 

  5. Benz, L. D. et al. Placental findings are not associated with neurodevelopmental outcome in neonates with hypoxic-ischemic encephalopathy - an 11-year single-center experience. J. Perinat. Med. 50, 343–350 (2022).

    Article  PubMed  Google Scholar 

  6. Chalak, L. et al. Acute and chronic placental abnormalities in a multicenter cohort of newborn infants with hypoxic-ischemic encephalopathy. J. Pediatr. 237, 190–196 (2021).

    Article  PubMed  Google Scholar 

  7. Vik, T. et al. The placenta in neonatal encephalopathy: a case-control study. J. Pediatr. 202, 77–85.e73 (2018).

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Pediatric Neurology Residency Program, Duke University Medical Center, Durham, NC, USA

    Alexa C. Stone

  2. Department of Pediatrics, Division of Neurology, Duke University Medical Center, Durham, NC, USA

    Jeffrey B. Russ

Authors
  1. Alexa C. Stone
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jeffrey B. Russ
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jeffrey B. Russ.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Stone, A.C., Russ, J.B. Systematic, prospective collection of placental specimens is crucial for future studies on the maternal-placental-fetal triad in neonatal encephalopathy. Pediatr Res (2023). https://doi.org/10.1038/s41390-023-03005-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1038/s41390-023-03005-2

Search

Advanced search

Quick links