Risk factors for uteroplacental vascular compromise and inflammation
Risk factors for uteroplacental vascular compromise and inflammation
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DOI：
10.1016/j.ajog.2008.06.055
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发表时间：
2008-09-01
影响因子：
9.8
通讯作者：
Thorp, John M.
中科院分区：
文献类型：
--
作者：
Baker, Arthur M.;Braun, Joe M.;Thorp, John M.
目的：本研究的目的是确定反映母体子宫胎盘血管损害（UPVC）以及急性和慢性胎盘炎症的胎盘损伤的潜在可改变危险因素。研究设计：进行了一项前瞻性流行病学研究。通过肉眼和显微镜检查对总共 1270 个胎盘进行了表征。胎盘病理状况以羊水感染综合征（AFIS）、慢性绒毛炎、UPVC 和胎儿血管阻塞性病变的特征进行编码。计算了 UPVC、急性和慢性炎症病变以及感兴趣的危险因素之间的优势比。结果：调整混杂因素后，我们发现有早产史的女性患慢性炎症的几率是其 1.60 倍（95% CI，1.10，2.55）。之前有过选择性终止妊娠的女性发生急性炎症的几率是其 3.28 倍（95% CI，1.89，5.70）。慢性绒毛炎的几率随着胎次的增加而增加； AFIS 的几率随着胎次的增加而降低。结论：我们已经确定了 UPVC、AFIS 和慢性绒毛炎的几个预测因素。需要进一步的研究来检验改变 UPVC、AFIS 和慢性绒毛炎的干预措施是否会改善妊娠结局。
OBJECTIVE: The purpose of this study was to identify potentially modifiable risk factors of placental injury that reflect maternal uteroplacental vascular compromise (UPVC) and acute and chronic placental inflammation. STUDY DESIGN: A prospective epidemiologic study was conducted. A total of 1270 placentas were characterized by gross and microscopic examination. Placental pathologic condition was coded for features of amniotic fluid infection syndrome (AFIS), chronic villitis, UPVC, and fetal vascular obstructive lesions. Odds ratios between UPVC, the acute and the chronic inflammatory lesions, and risk factors of interest were calculated. RESULTS: After adjustment for confounders, we found that women with a history of preterm birth had 1.60 times the odds of chronic inflammation (95% CI, 1.10, 2.55). Women with a previous elective termination had 3.28 times the odds of acute inflammation (95% CI, 1.89, 5.70). The odds of chronic villitis increased with parity; the odds of AFIS decreased with parity. CONCLUSION: We have identified several predictors of UPVC, AFIS, and chronic villitis. Further studies are needed to examine whether interventions to alter UPVC, AFIS, and chronic villitis will lead to improved pregnancy outcomes.