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Chorioamnionitis without foetal inflammatory response is associated with stillbirth in early preterm pregnancies.
MedLine Citation:
PMID:  23339524     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract Objective: The aim of this study was to compare placental findings from early preterm stillbirths with gestational week-matched liveborn infants. The main focus was to investigate the differences in the presence and distribution of inflammatory signs in the placentas of these two groups, especially referring to histological acute chorioamnionitis (CAM). Methods: A case-control study of preterm stillbirths, between 22 and 32 weeks´ gestation, here referred to as early preterm, (cases, n=112) and gestational week-matched liveborn infants (references, n=166) in Stockholm. Relevant clinical data were collected from a web-based database (for cases) and delivery records (for references). Macroscopic and histological examinations of placentas were performed according to a structured protocol (placental weight relative to gestational age, accelerated villous maturation, infarction, intervillous thrombosis, foetal thrombosis, chronic villitis and CAM (polymorphonuclear leucocytes in the chorion/amnion), with and without foetal inflammatory responses (vasculitis in placental and/or cord vessels and funisitis). Statistical analyses were performed using a multivariable logistic regression. Results: Small for gestational age (AOR: 2.13 CI: 1.26-3.62) and CAM without a foetal inflammatory response (AOR: 2.44 CI: 1.10-5.41) were associated with an elevated risk of preterm stillbirth. Conclusions: Histological acute chorioamnionitis without a foetal inflammatory response is associated with a higher risk for stillbirth in early preterm pregnancies.
Authors:
Ingela Hulthén Varli; Marius Kublickas; Nikos Papadogiannakis; Karin Petersson
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-22
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  -     ISSN:  1476-4954     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Obstetrics and Gynaecology, Karolinska University Hospital, Solna and Karolinska Institutet.
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