Placental pathology as a predisposing factor to intraventricular hemorrhage remains a matter of debate, and its contribution to cerebellar hemorrhage development is still largely unexplored. Our study aimed to assess placental and perinatal risk factors for intraventricular and cerebellar hemorrhages in preterm infants. This retrospective cohort study included very low-birth weight infants born at the Gaslini Children's Hospital between January 2012 and October 2016 who underwent brain magnetic resonance with susceptibility-weighted imaging at term-equivalent age and whose placenta was analyzed according to the Amsterdam Placental Workshop Group Consensus Statement. Of the 286 neonates included, 68 (23.8%) had intraventricular hemorrhage (all grades) and 48 (16.8%) had a cerebellar hemorrhage (all grades). After correction for gestational age, chorioamnionitis involving the maternal side of the placenta was found to be an independent risk factor for developing intraventricular hemorrhage, whereas there was no association between maternal and fetal inflammatory response and cerebellar hemorrhage. Among perinatal factors, we found that intraventricular hemorrhage was significantly associated with cerebellar hemorrhage (odds ratio [OR], 8.14), mechanical ventilation within the first 72 h (OR, 2.67), and patent ductus arteriosus requiring treatment (OR, 2.6), whereas cesarean section emerged as a protective factor (OR, 0.26). Inotropic support within 72 h after birth (OR, 5.24) and intraventricular hemorrhage (OR, 6.38) were independent risk factors for cerebellar hemorrhage, whereas higher gestational age was a protective factor (OR, 0.76). Assessing placental pathology may help in understanding mechanisms leading to intraventricular hemorrhage, although its possible role in predicting cerebellar bleeding needs further evaluation.

中文翻译：

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早产儿的胎盘病理发现和脑室内和小脑出血的风险。

胎盘病理作为脑室内出血的诱因仍是一个有争议的问题，其在小脑出血发展中的作用仍未得到充分研究。我们的研究旨在评估早产儿脑室内和小脑出血的胎盘和围产期危险因素。这项回顾性队列研究包括2012年1月至2016年10月在加斯利尼儿童医院出生的极低出生体重婴儿，他们在足当龄时接受了脑磁共振和药敏加权成像，并且根据阿姆斯特丹胎盘研究小组对胎盘进行了分析。共识声明。在286名新生儿中，有68名（23.8％）发生了脑室内出血（所有级别），而48名（16.8％）发生了小脑出血（所有级别）。修正胎龄后，绒毛膜羊膜炎累及胎盘的母亲一侧被发现是发生脑室内出血的独立危险因素，而母亲和胎儿的炎症反应与小脑出血之间没有关联。在围产期因素中，我们发现脑室内出血与小脑出血（比值比[OR]，8.14），头72小时内的机械通气（OR，2.67）以及需要治疗的动脉导管未闭（OR，2.6）显着相关，而剖宫产成为保护因素（OR，0.26）。出生后72小时内的正性肌力支持（OR，5.24）和脑室内出血（OR，6.38）是小脑出血的独立危险因素，而较高的胎龄是保护因素（OR，0.76）。