{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T18:25:25Z","timestamp":1770056725807,"version":"3.49.0"},"reference-count":75,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2021,12,3]],"date-time":"2021-12-03T00:00:00Z","timestamp":1638489600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Placental abruption (PA) is a concern for maternal and neonatal morbidity. Adverse neonatal outcomes in the setting of PA include higher risk of prematurity. Placental pathologies include maternal vascular malperfusion (MVM), fetal vascular malperfusion (FVM), acute chorioamnionitis, and villitis of unknown etiology (VUE). We aimed to investigate how placental pathology contributes to acute neonatal outcome in PA. A retrospective cohort study of all placentas with PA were identified. Exposures were MVM, FVM, acute chorioamnionitis and VUE. The primary outcome was NICU admission and the secondary outcomes included adverse base deficit and Apgar scores, need for resuscitation, and small-for-gestational age. A total of 287 placentas were identified. There were 160 (59.9%) of placentas with PA alone vs 107 (40.1%) with PA and additional placental pathologies. Odds of NICU admission were more than two times higher in pregnancies with placental pathologies (OR = 2.37, 95% CI 1.28\u20134.52). These estimates were in large part mediated by prematurity and birthweight, indirect effect acting through prematurity was OR 1.79 (95% CI 1.12\u20132.75) and through birthweight OR 2.12 (95% CI 1.40\u20133.18). Odds of Apgar score \u2264 5 was more than four times higher among pregnancies with placental pathologies (OR = 4.56, 95% CI 1.28\u201321.26). Coexisting placental pathology may impact Apgar scores in pregnancies complicated by PA. This knowledge could be used by neonatal teams to mobilize resources in anticipation of the need for neonatal resuscitation.<\/jats:p>","DOI":"10.3390\/jcm10235693","type":"journal-article","created":{"date-parts":[[2021,12,5]],"date-time":"2021-12-05T21:01:45Z","timestamp":1638738105000},"page":"5693","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Impact of Co-Existing Placental Pathologies in Pregnancies Complicated by Placental Abruption and Acute Neonatal Outcomes"],"prefix":"10.3390","volume":"10","author":[{"given":"Dorsa","family":"Mavedatnia","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Tran","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irina","family":"Oltean","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada"},{"name":"Department of Pathology, Children\u2019s Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vid","family":"Bijeli\u0107","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felipe","family":"Moretti","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Lawrence","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dina","family":"El Demellawy","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Ottawa, Ottawa, ON K1H 8M5, Canada"},{"name":"Department of Pathology, Children\u2019s Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1053\/j.semperi.2014.03.001","article-title":"Ischemic Placental Disease: A Unifying Concept for Preeclampsia, Intrauterine Growth Restriction, and Placental Abruption","volume":"38","author":"Ananth","year":"2014","journal-title":"Semin. Perinatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.ejogrb.2009.10.005","article-title":"Diagnosis of Placental Abruption: Relationship between Clinical and Histopathological Findings","volume":"148","author":"Elsasser","year":"2010","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Ananth, C.V., Keyes, K.M., Hamilton, A., Gissler, M., Wu, C., Liu, S., Luque-Fernandez, M.A., Skj\u00e6rven, R., Williams, M.A., and Tikkanen, M. (2015). An International Contrast of Rates of Placental Abruption: An Age-Period-Cohort Analysis. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0125246"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1111\/j.1600-0412.2010.01030.x","article-title":"Placental Abruption: Epidemiology, Risk Factors and Consequences","volume":"90","author":"Tikkanen","year":"2011","journal-title":"Acta Obstet. Gynecol. Scand."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1646","DOI":"10.1001\/jama.282.17.1646","article-title":"Placental Abruption and Adverse Perinatal Outcomes","volume":"282","author":"Ananth","year":"1999","journal-title":"J. Am. Med. Assoc."},{"key":"ref_6","first-page":"1","article-title":"Maternal Cardiovascular and Cerebrovascular Health after Placental Abruption: A Systematic Review and Meta-Analysis","volume":"143","author":"Ananth","year":"2021","journal-title":"Am. J. Epidemiol."},{"key":"ref_7","first-page":"2278","article-title":"A Retrospective Study on Adherent Placenta\u2014Its Management, Maternal and Perinatal Outcome","volume":"6","author":"Dandapat","year":"2017","journal-title":"J. Evol. Med. Dent. Sci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"4389","DOI":"10.18203\/2320-1770.ijrcog20174410","article-title":"Abruptio Placenta: A Retrospective Study on Maternal and Perinatal Outcome","volume":"6","author":"Sengodan","year":"2017","journal-title":"Int. J. Reprod. Contracept. Obstet. Gynecol."},{"key":"ref_9","first-page":"57","article-title":"Frequency, Predictors and Outcomes of Placental Abruption in Rural Sindh","volume":"60","author":"Soomro","year":"2021","journal-title":"Pak. J. Med. Res."},{"key":"ref_10","first-page":"1","article-title":"Immediate Maternal and Fetal Outcome of Placental Abruption\/ Omdurman\/ SUDAN (Multicentric Study)","volume":"41","author":"Satti","year":"2021","journal-title":"Multi-Knowl. Electron. Compr. J. Educ. Sci. Publ."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2952","DOI":"10.1080\/14767058.2019.1675625","article-title":"Clinical Analysis and Classification of Placental Abruption","volume":"34","author":"Qiu","year":"2021","journal-title":"J. Matern. Neonatal Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/S0029-7844(96)00478-4","article-title":"Etiologic Determinants of Abruptio Placenta","volume":"89","author":"Kramer","year":"1997","journal-title":"Obstet. Gynecol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3775","DOI":"10.1080\/14767058.2019.1585424","article-title":"The Impact of the Abruption Severity and the Onset-to-Delivery Time on the Maternal and Neonatal Outcomes of Placental Abruption","volume":"33","author":"Onishi","year":"2020","journal-title":"J. Matern. Neonatal Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1097\/01.ogx.0000550504.16932.81","article-title":"Simulation Training Is Useful for Shortening the Decision-To-Delivery Interval in Cases of Emergent Cesarean Section","volume":"74","author":"Iitani","year":"2019","journal-title":"Obstet. Gynecol. Surv."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/j.ijoa.2012.03.004","article-title":"The National Institute for Health and Clinical Excellence (NICE) Guidelines for Caesarean Section, 2011 Update: Implications for the Anaesthetist","volume":"21","author":"Soltanifar","year":"2012","journal-title":"Int. J. Obstet. Anesth."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"698","DOI":"10.5858\/arpa.2015-0225-CC","article-title":"Sampling and Definitions of Placental Lesions Amsterdam Placental Workshop Group Consensus Statement","volume":"140","author":"Khong","year":"2016","journal-title":"Arch. Pathol. Lab. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1097\/AOG.0000000000002264","article-title":"Maternal Vascular Malperfusion and Adverse Perinatal Outcomes in Low-Risk Nulliparous Women","volume":"130","author":"Wright","year":"2017","journal-title":"Obstet. Gynecol."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Awuah, S.P., Okai, I., Ntim, E.A., and Bedu-Addo, K. (2020). Prevalence, Placenta Development, and Perinatal Outcomes of Women with Hypertensive Disorders of Pregnancy at Komfo Anokye Teaching Hospital. PLoS ONE, 15.","DOI":"10.1101\/2020.05.14.095760"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.placenta.2016.11.004","article-title":"Placental Maternal Vascular Malperfusion and Adverse Pregnancy Outcomes in Gestational Diabetes Mellitus","volume":"49","author":"Scifres","year":"2017","journal-title":"Placenta"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1484","DOI":"10.5858\/arpa.2017-0212-RA","article-title":"Fetal Vascular Malperfusion","volume":"141","author":"Heider","year":"2017","journal-title":"Arch. Pathol. Lab. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.placenta.2017.02.016","article-title":"Maternal Vascular Malperfusion of the Placental Bed Associated with Hypertensive Disorders in the Boston Birth Cohort","volume":"52","author":"Chilukuri","year":"2017","journal-title":"Placenta"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.placenta.2019.09.003","article-title":"Maternal Vascular Malformation in the Placenta Is an Indicator for Fetal Growth Restriction Irrespective of Neonatal Birthweight","volume":"87","author":"Hendrix","year":"2019","journal-title":"Placenta"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1007\/s10024-003-8083-2","article-title":"Maternal Vascular Underperfusion: Nosology and Reproducibility of Placental Reaction Patterns","volume":"7","author":"Redline","year":"2004","journal-title":"Pediatr. Dev. Pathol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2759","DOI":"10.1080\/14767058.2019.1670811","article-title":"Maternal Vascular Malperfusion in Spontaneous Preterm Birth Placentas Related to Clinical Outcome of Subsequent Pregnancy","volume":"34","author":"Visser","year":"2021","journal-title":"J. Matern. Neonatal Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/0002-9378(93)90499-9","article-title":"Maternal Placental Vasculopathy and Infection: Two Distinct Subgroups among Patients with Preterm Labor and Preterm Ruptured Membranes","volume":"168","author":"Arias","year":"1993","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1093\/aje\/kwp131","article-title":"Placental Vascular Pathology Findings and Pathways to Preterm Delivery","volume":"170","author":"Holzman","year":"2009","journal-title":"Am. J. Epidemiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1067\/mob.2002.127720","article-title":"Failure of Physiologic Transformation of the Spiral Arteries in the Placental Bed in Preterm Premature Rupture of Membranes","volume":"187","author":"Kim","year":"2002","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Christians, J.K., and Huicochea Munoz, M.F. (2020). Pregnancy Complications Recur Independently of Maternal Vascular Malperfusion Lesions. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0228664"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/j.ajog.2004.07.030","article-title":"Severe Fetal Placental Vascular Lesions in Term Infants with Neurologic Impairment","volume":"192","author":"Redline","year":"2005","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1111\/apm.12849","article-title":"Fetal Vascular Malperfusion, an Update","volume":"126","author":"Redline","year":"2018","journal-title":"Apmis"},{"key":"ref_31","first-page":"909","article-title":"Chorioamnionitis and Uterine Function","volume":"95","author":"Mark","year":"2000","journal-title":"Obstet. Gynecol."},{"key":"ref_32","first-page":"913","article-title":"Chorioamnionitis: A Harbinger of Dystocia","volume":"79","author":"Satin","year":"1992","journal-title":"Obstet. Gynecol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/j.clp.2010.02.003","article-title":"Diagnosis and Management of Clinical Chorioamnionitis","volume":"37","author":"Tita","year":"2010","journal-title":"Clin. Perinatol."},{"key":"ref_34","first-page":"59","article-title":"Term Maternal and Neonatal Complications of Acute Chorioamnionitis","volume":"66","author":"Hauth","year":"1985","journal-title":"Obstet. Gynecol."},{"key":"ref_35","first-page":"183","article-title":"The Effect of Chorioamnionitis on the Developmental Outcome of Preterm Infants at One Year","volume":"70","author":"Morales","year":"1987","journal-title":"Obstet. Gynecol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1016\/j.ajog.2005.01.017","article-title":"Chorioamnionitis with a Fetal Inflammatory Response Is Associated with Higher Neonatal Mortality, Morbidity, and Resource Use than Chorioamnionitis Displaying a Maternal Inflammatory Response Only","volume":"193","author":"Lau","year":"2005","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"780","DOI":"10.3109\/14767050902922581","article-title":"Neonatal Outcomes in the Setting of Preterm Premature Rupture of Membranes Complicated by Chorioamnionitis","volume":"22","author":"Aziz","year":"2009","journal-title":"J. Matern. Neonatal Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1016\/j.humpath.2007.05.025","article-title":"Villitis of Unknown Etiology: Noninfectious Chronic Villitis in the Placenta","volume":"38","author":"Redline","year":"2007","journal-title":"Hum. Pathol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1007\/s11606-020-05669-6","article-title":"Development and Establishment of Initial Validity Evidence for a Novel Tool for Assessing Trainee Admission Notes","volume":"35","author":"Weber","year":"2020","journal-title":"J. Gen. Intern. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"103208","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap Consortium: Building an International Community of Software Platform Partners","volume":"95","author":"Harris","year":"2019","journal-title":"J. Biomed. Inform."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1097\/00001648-199901000-00008","article-title":"Causal Diagrams for Epidemiologic Research","volume":"10","author":"Greenland","year":"1999","journal-title":"Epidemiology"},{"key":"ref_42","unstructured":"R Core Team (2020). R: A Language and Environment for Statistical Computing, R Foundation for Statistical Computing. Available online: https:\/\/www.R-project.org\/."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Steen, J., Loeys, T., Moerkerke, B., and Vansteelandt, S. (2017). Medflex: An R Package for Flexible Mediation Analysis Using Natural Effect Models. J. Stat. Softw., 76.","DOI":"10.18637\/jss.v076.i11"},{"key":"ref_44","first-page":"1887","article-title":"Robust Causal Inference Using Directed Acyclic Graphs: The R Package \u201cDagitty\u201d","volume":"45","author":"Textor","year":"2016","journal-title":"Int. J. Epidemiol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1093\/aje\/kwx202","article-title":"Neonatal Outcomes Associated with Placental Abruption","volume":"186","author":"Downes","year":"2017","journal-title":"Am. J. Epidemiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1080\/jmf.13.1.45.49","article-title":"Placental Abruption in Term Pregnancies: Clinical Significance and Obstetric Risk Factors","volume":"13","author":"Sheiner","year":"2003","journal-title":"J. Matern. Neonatal Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1016\/0029-7844(95)00483-1","article-title":"The Epidemiology of Placental Features: Associations with Gestational Age and Neonatal Outcome","volume":"5","author":"Beebe","year":"1996","journal-title":"Obstet. Gynecol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1080\/jmf.13.2.102.109","article-title":"The Relationship between Placental Histopathology Findings and Perinatal Outcome in Preterm Infants","volume":"13","author":"Ogunyemi","year":"2003","journal-title":"J. Matern. Neonatal Med."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Roescher, A.M., Timmer, A., Erwich, J.J.H.M., and Bos, A.F. (2014). Placental Pathology, Perinatal Death, Neonatal Outcome, and Neurological Development: A Systematic Review. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0089419"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1097\/01.AOG.0000209197.84185.15","article-title":"Umbilical Coiling Index in Normal and Complicated Pregnancies","volume":"107","author":"Franx","year":"2006","journal-title":"Obstet. Gynecol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"579.e1","DOI":"10.1016\/j.ajog.2010.08.024","article-title":"Placental Pathology in Asphyxiated Newborns Meeting the Criteria for Therapeutic Hypothermia","volume":"203","author":"Wintermark","year":"2010","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1016\/j.ajog.2006.03.053","article-title":"Preterm Histologic Chorioamnionitis: Impact on Cord Gas and PH Values and Neonatal Outcome","volume":"195","author":"Richardson","year":"2006","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1111\/j.1447-0756.2010.01519.x","article-title":"Severity of Chorioamnionitis and Neonatal Outcome","volume":"37","author":"Sato","year":"2011","journal-title":"J. Obstet. Gynaecol. Res."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.siny.2008.08.011","article-title":"Prenatal Inflammation and Lung Development","volume":"14","author":"Kramer","year":"2009","journal-title":"Semin. Fetal Neonatal Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1126\/science.2821621","article-title":"Interleukin-1 Stimulates the Secretion of Hypothalamic Corticotropin- Releasing Factor","volume":"238","author":"Sapolsky","year":"1987","journal-title":"Science"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1097\/00006254-198807000-00016","article-title":"Release of Multiple Hormones by a Direct Action of Lnterleukin-1 on Pituitary Cells","volume":"43","author":"Bernton","year":"1988","journal-title":"Obstet. Gynecol. Surv."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1111\/1440-1681.12166","article-title":"Regulation of Fetal Lung Development in Response to Maternal Overnutrition","volume":"40","author":"Lock","year":"2013","journal-title":"Clin. Exp. Pharmacol. Physiol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"2992","DOI":"10.1172\/JCI119494","article-title":"Intraamniotic Interleukin-1 Accelerates Surfactant Protein Synthesis in Fetal Rabbits and Improves Lung Stability after Premature Birth","volume":"99","author":"Bry","year":"1997","journal-title":"J. Clin. Investig."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1203\/00006450-200012000-00014","article-title":"Antenatal Endotoxin and Glucocorticoid Effects on Lung Morphometry in Preterm Lambs","volume":"48","author":"Willet","year":"2000","journal-title":"Pediatr. Res."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.jpeds.2008.07.012","article-title":"Blood Cytokines during the Perinatal Period in Very Preterm Infants","volume":"154","author":"Paananen","year":"2009","journal-title":"J. Pediatr."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.ejogrb.2014.05.026","article-title":"Placental Abruption: Risk Factors, Management and Maternal-Fetal Prognosis. Cohort Study over 10 Years","volume":"179","author":"Fritz","year":"2014","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"705","DOI":"10.3109\/14767058.2014.929109","article-title":"The Effect of Placental Abruption on the Outcome of Extremely Premature Infants","volume":"28","author":"Furukawa","year":"2015","journal-title":"J. Matern. Neonatal Med."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"303.e1","DOI":"10.1016\/j.ajog.2007.07.009","article-title":"Predictors of Umbilical Artery Acidosis in Preterm Delivery","volume":"197","author":"Andreani","year":"2007","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1055\/s-0037-1599149","article-title":"Maternal, Labor, Delivery, and Perinatal Outcomes Associated with Placental Abruption: A Systematic Review","volume":"34","author":"Downes","year":"2017","journal-title":"Am. J. Perinatol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1136\/bmj.c4990","article-title":"Association of Cerebral Palsy with Apgar Score in Low and Normal Birthweight Infants: Population Based Cohort Study","volume":"341","author":"Lie","year":"2010","journal-title":"BMJ"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1067\/mpd.2001.114694","article-title":"The Association of Apgar Score with Subsequent Death and Cerebral Palsy: A Population-Based Study in Term Infants","volume":"138","author":"Moster","year":"2001","journal-title":"J. Pediatr."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1097\/01.AOG.0000247174.27979.6b","article-title":"Perinatal Factors Associated with Cerebral Palsy in Children Born in Sweden","volume":"108","author":"Herbst","year":"2006","journal-title":"Obstet. Gynecol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1016\/S0022-3476(96)70292-5","article-title":"Prenatal and Perinatal Factors and Cerebral Palsy in Very Low Birth Weight Infants","volume":"128","author":"Grether","year":"1996","journal-title":"J. Pediatr."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1542\/peds.101.1.77","article-title":"The Apgar Score and Its Components in the Preterm Infant","volume":"101","author":"Hegyi","year":"1998","journal-title":"Pediatrics"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1136\/adc.2008.145037","article-title":"The Apgar Cycle: A New View of a Familiar Scoring System","volume":"94","author":"Pinheiro","year":"2009","journal-title":"Arch. Dis. Child. Fetal Neonatal Ed."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1002\/ijc.22322","article-title":"Renal Cell Carcinoma Does Not Express Argininosuccinate Synthetase and Is Highly Sensitive to Arginine Deprivation via Arginine Deiminase","volume":"120","author":"Yoon","year":"2007","journal-title":"Int. J. Cancer"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1002\/1531-8249(200001)47:1<54::AID-ANA10>3.0.CO;2-Y","article-title":"Proinflammatory Cytokines and Interleukin-9 Exacerbate Excitotoxic Lesions of the Newborn Murine Neopallium","volume":"47","author":"Dommergues","year":"2000","journal-title":"Ann. Neurol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"S40","DOI":"10.1016\/S0002-9378(97)80173-1","article-title":"Experimentally-Induced Intrauterine Infection Causes Fetal Brain White Matter Lesions in Rabbits","volume":"176","author":"Yoon","year":"2000","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1001\/jama.284.11.1417","article-title":"Chorioamnionitis as a Risk Factor for Cerebral Palsy A Meta-Analysis","volume":"284","author":"Wu","year":"2000","journal-title":"J. Am. Med. Assoc."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1067\/mob.2000.104207","article-title":"Fetal Exposure to an Intra-Amniotic Inflammation and the Development of Cerebral Palsy at the Age of Three Years","volume":"182","author":"Yoon","year":"2000","journal-title":"Am. J. Obstet. 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