Placental windows into neonatal encephalopathy

Despite the appropriate use of therapeutic hypothermia, neurodevelopmental impairments occur in a significant number of infants with neonatal encephalopathy. This may be related to our limited understanding of the nature and timing of the inciting events for many patients with neonatal encephalopathy. Further understanding of this problem requires the opening of a window into the past, before the birth, to evaluate what may have occurred before any clinical signs of fetal compromise. The placenta may provide this window, and placental lesions have shown associations with patterns of brain injury and developmental outcomes in neonatal encephalopathy (J Pediatr 2013;163:968-95; Am J Obstet Gynecol 2015;231:849.e1-7).

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