Trophoblast inclusions and adverse birth outcomes.
Trophoblast inclusions and adverse birth outcomes.
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DOI：
10.1371/journal.pone.0264733
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发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
Fifer WP
中科院分区：
文献类型：
--
作者：
Firestein MR;Kliman HJ;Sania A;Brink LT;Holzer PH;Hofmann KM;Milano KM;Pini N;Shuffrey LC;Odendaal HJ;Fifer WP
滋养层内含物--异常滋养层双层折叠的横截面--以前曾与非整倍体、胎盘植入和早产有关。这项研究是为了建立滋养层包涵体与一系列胎盘、妊娠和出生结局之间的关系，在一个高吸烟和酒精暴露的患者群体中进行。具体地说，我们试图评估滋养层包涵体的存在与1)三种主要出生结局之间的关系：足月出生、早产和死产；2)分娩时的胎龄；以及3)特定的胎盘病理。从南非开普敦StellenBosch大学收集的589个胎盘中，对含有绒毛的两张幻灯片进行了评估，这是产前酒精与小岛屿发展中国家和静产网络前瞻性多中心队列安全通道研究的一部分。亚样本包括307名足月活产、212名早产活产和70名死产。我们发现，早产胎盘与足月活产胎盘相比，在两张绒毛切片上识别至少一个滋养细胞包涵体的几率显著高于足月活产胎盘(OR=1.74；95%CI：1.22，2.49，p=0.002)，死产胎盘与足月活产胎盘的比值比更高(OR=4.95；95%CI：2.78，8.8，p<；0.001)。分娩时的胎龄与滋养层包涵体频率呈负相关。滋养层包涵体与小于胎龄、出生体重、引产、绒毛水肿、胎盘梗死和绒毛膜板炎症显著相关。我们报告的这些新的关联值得进一步研究，以了解导致滋养细胞包涵体的因素可能影响或反映妊娠轨迹和健康的复杂的生物学机制网络。最终，这一系列研究可能会提供关键的见解，为临床和研究应用提供信息。
Trophoblast inclusions—cross sections of abnormal trophoblast bilayer infoldings—have previously been associated with aneuploidy, placenta accreta, and prematurity. This study was conducted to establish the relationship between trophoblast inclusions and a range of placental, pregnancy, and birth outcomes in a patient population with high smoking and alcohol exposure. Specifically, we sought to evaluate the association between the presence of trophoblast inclusions and 1) three primary birth outcomes: full-term birth, preterm birth, and stillbirth; 2) gestational age at delivery; and 3) specific placental pathologies. Two slides containing chorionic villi were evaluated from 589 placentas that were collected from Stellenbosch University in Cape Town, South Africa as part of the prospective, multicenter cohort Safe Passage Study of the Prenatal Alcohol and SIDS and Stillbirth Network. The subsample included 307 full-term live births, 212 preterm live births, and 70 stillbirths. We found that the odds of identifying at least one trophoblast inclusion across two slides of chorionic villi was significantly higher for placentas from preterm compared to term liveborn deliveries (OR = 1.74; 95% CI: 1.22, 2.49, p = 0.002), with an even greater odds ratio for placentas from stillborn compared to term liveborn deliveries (OR = 4.95; 95% CI: 2.78, 8.80, p < 0.001). Gestational age at delivery was inversely associated with trophoblast inclusion frequency. Trophoblast inclusions were significantly associated with small for gestational age birthweight, induction of labor, villous edema, placental infarction, and inflammation of the chorionic plate. The novel associations that we report warrant further investigation in order to understand the complex network of biological mechanisms through which the factors that lead to trophoblast inclusions may influence or reflect the trajectory and health of a pregnancy. Ultimately, this line of research may provide critical insights that could inform both clinical and research applications.
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