Document Detail


Placental chorioamnionitis at term: epidemiology and follow-up in childhood.
MedLine Citation:
PMID:  19888869     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The objective was to identify histologic chorioamnionitis ("amnionitis") in the placental disc at term and to investigate associations with demographic, lifestyle, and pregnancy factors and with allergic diseases, atopy, and intelligence quotients in childhood. The setting was a population-based case control study of small-for-gestational age infants at term. One thousand and twelve placentas were assessed histologically for amniocentric inflammation of fetal and/or maternal origin using conservative criteria. Data were collected at birth by maternal interview and from medical records. Follow-up data were obtained from 439 and 418 children at 3.5 and 7 years of age, respectively. Amnionitis was identified in 145 placentas (14.3%), with maternal reaction in 97.2% and fetal reaction in 48.3%. In multivariable analysis any amnionitis was significantly associated with a time from membrane rupture to delivery of 6 to 12 hours, but not with times beyond 12 hours, a duration of total labor exceeding 12 hours, ethnicity (incidences ranging from 8.8% in Indians to 23.5% in Chinese), male infant gender, and anaesthesia during labor, and amnionitis was negatively associated with induction of labor. No associations were found with later allergic disease, atopy, or intelligence quotients. This high incidence of histologic amnionitis at term is similar to historical estimates, despite large reductions in time-related risk factors during labor. Significant ethnic variations contribute to the high incidence and are unexplained, but variation in genetic polymorphisms for susceptibility factors is a possibility. "Silent" histologic amnionitis is a frequent cause of fetal immune activation with potential effects in later life.
Authors:
David M O Becroft; John M D Thompson; Ed A Mitchell
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society     Volume:  13     ISSN:  1093-5266     ISO Abbreviation:  Pediatr. Dev. Pathol.     Publication Date:    2010 Jul-Aug
Date Detail:
Created Date:  2010-10-07     Completed Date:  2010-11-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9809673     Medline TA:  Pediatr Dev Pathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  282-90     Citation Subset:  IM    
Affiliation:
Department of Paediatrics, University of Auckland, Private Bag 92019, Auckland, New Zealand.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Case-Control Studies
Child
Child, Preschool
Chorioamnionitis / diagnosis*,  epidemiology*,  etiology
Ethnic Groups
Female
Follow-Up Studies
Humans
Infant, Newborn
Male
New Zealand / epidemiology
Placenta / pathology*
Polymorphism, Genetic
Pregnancy
Questionnaires
Risk Factors
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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