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Is there a role for placental histopathology in predicting the recurrence of preterm birth?

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Spontaneous preterm birth (sPTB) is a major cause of neonatal morbidity and mortality with a relatively high rate to recurrence. Our aim was to study the role of placental histopathology in predicting recurrence of sPTB.

Methods

We conducted a retrospective cohort study. The medical records and placental pathologic reports of all women with sPTB (gestational age 230/7–366/7 weeks), during 2008–2015, were reviewed. Only women who had a subsequent delivery were included. Multiple pregnancies and women with known uterine anomalies were excluded. Placental histopathology lesions were classified into maternal and fetal vascular malperfusion lesions, acute maternal and fetal inflammatory responses lesions, and chronic inflammatory lesions. Placental lesions were compared between patients with and without recurrent sPTB on their subsequent pregnancies.

Results

Maternal characteristics, gestational age, birthweight, and the rate of preterm rupture of membrane at index delivery were similar between the recurrent sPTB (n = 72) and the non-recurrent sPTB (n = 167) groups. The incidence of placental vascular malperfusion lesions, or inflammatory lesions did not differ between the study groups. However, on multivariate logistic regression analysis, the presence of only acute inflammatory response lesions was associated with recurrence of early sPTB ( < 34 weeks) (adjusted OR 3.16; 95% CI 1.22–8.18).

Conclusion

The presence of isolated placental acute maternal or fetal inflammatory response in index sPTB may be associated with recurrence of early sPTB.

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Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, The Edith Wolfson Medical Center, P.O. Box 5, 5822012, Holon, Israel

    Yossi Mizrachi, Elad Barber, Maya Torem, Daniel Tairy, Eran Weiner, Jacob Bar & Michal Kovo

  2. Department of Pathology, The Edith Wolfson Medical Center, Holon, Israel

    Letizia Schreiber

  3. Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel

    Yossi Mizrachi, Elad Barber, Maya Torem, Daniel Tairy, Eran Weiner, Jacob Bar, Letizia Schreiber & Michal Kovo

Authors
  1. Yossi Mizrachi
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  2. Elad Barber
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  3. Maya Torem
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  4. Daniel Tairy
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  5. Eran Weiner
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  6. Jacob Bar
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  7. Letizia Schreiber
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  8. Michal Kovo
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Contributions

YM: project development, data collection and management, data analysis, and manuscript writing. EB: data collection and manuscript editing. MT: data collection and manuscript editing. DT: data collection and manuscript editing. EW: data collection and manuscript editing. JB: data collection and manuscript editing. LS: data collection and manuscript editing. MK: project development, data collection and management, data analysis, and manuscript writing.

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Correspondence to Yossi Mizrachi.

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Mizrachi, Y., Barber, E., Torem, M. et al. Is there a role for placental histopathology in predicting the recurrence of preterm birth?. Arch Gynecol Obstet 300, 917–923 (2019). https://doi.org/10.1007/s00404-019-05266-x

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  • DOI: https://doi.org/10.1007/s00404-019-05266-x

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