2132. Placental histopathology and long-term outcomes of children with antenatal Zika virus exposure

Abstract

Abstract Background It is unclear whether placental changes in ZIKV infection influence short- and long-term child outcomes. The objective of this study is to determine if placental histopathology findings in ZIKV correlate with offspring outcomes at birth and age 4-5 years for children with in utero ZIKV exposure without congenital Zika syndrome. Methods 24 placentas collected from pregnant women with symptomatic ZIKV infection enrolled in a prospective ZIKV study in Colombia were formalin fixed and reviewed by a placental pathologist, blinded to child outcome. Children had neuroimaging as newborns and were longitudinally evaluated to age 4-5 years with the Bracken School Readiness Assessment (BSRA) and Pediatric Evaluation of Disability Inventory (PEDI-CAT). Scores were compared by presence of placental findings of perivillous fibrin deposition, calcifications, and increased syncytial knotting. T-test, fisher exact, and one way ANOVA were used for analysis; significance, p< .05. Results All 24 placentas had at least one abnormal pathological finding (Table 1). 14 (58%) placentas had extensive ( >30% coverage) and 7 (29%) had mild-moderate perivillous fibrin deposition (Fig. 1a). Placental calcifications were many ( >10) in 10 (42%) cases, and mild in 7 (29%) cases (Fig. 1b). 14 (58%) placentas had increased syncytial knotting. Placentas stained positive with CD163 for Hofbauer macrophages (Fig. 1c). All infants were born at term with normal birth weight, height, and head circumference, and 22 had a normal ponderal index. There was no difference in measurements based on each placental finding. There was no relationship between placental findings and non-specific neuroimaging. 20 (83%) children with placentas were evaluated at age 4-5. Children without placental calcifications scored higher on BSRA than children with mild/severe calcifications (p = .031). Children with increased syncytial knotting had lower scores on PEDI-CAT social/cognitive ability (p = .024). Conclusion Placentas from ZIKV-infected pregnancies have pathological findings that indicate risk of impaired fetal perfusion, but these were not associated with preterm birth or growth. There may be associations between placental findings and long-term neurodevelopment in ZIKV-exposed children requiring additional studies. Disclosures All Authors: No reported disclosures.