Document Detail


Placental inflammation and viral infection are implicated in second trimester pregnancy loss.
MedLine Citation:
PMID:  16949414     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Second trimester pregnancy loss continues to be a poorly understood adverse obstetric outcome. A case control study was performed to determine if: (1) similar to early spontaneous preterm birth, second trimester loss is associated with histologic chorioamnionitis (HCA); and (2) if HCA is present, which organisms may mediate this placental inflammation. STUDY DESIGN: Cases were patients with a spontaneous second trimester loss. Controls were patients who presented for induction of labor for fetal or maternal indications. Nested polymerase chain reaction (PCR) was performed on placental tissues to detect the presence of viruses and pathogenic and atypical bacteria. Chi-square and Fisher exact test were used to determine if HCA and/or the presence of virus or bacteria were significantly associated with second trimester loss. The associations of interest were adjusted for possible confounders using multivariable logistic regression. RESULTS: HCA was more prevalent in cases (67%) than controls (16%) (P < .001). Seventy-nine percent (66/84) of cases and 44% (7/16) of controls were positive for any virus (P = .01). The rate of bacterial infection was similar in both cases and controls (P = .35). In multivariable logistic regression models, HCA (odds ratio [OR] 14.58, 2.62-81.15) and the presence of any virus (OR 6.62, 1.56-28.07) were independently associated with second trimester loss. CONCLUSION: These studies demonstrate that spontaneous second trimester loss is strongly associated with HCA and viral infections.
Authors:
Sindhu K Srinivas; Yujie Ma; Mary D Sammel; Doris Chou; Cindy McGrath; Samuel Parry; Michal A Elovitz
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  195     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-09-04     Completed Date:  2006-10-06     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  797-802     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, University of Pennsylvania Health System, Philadelphia, PA, USA. ssrinivas@obgyn.upenn.edu
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MeSH Terms
Descriptor/Qualifier:
Abortion, Spontaneous / epidemiology,  microbiology,  pathology*,  virology*
Adult
Case-Control Studies
Chorioamnionitis / epidemiology,  pathology*
Female
Gestational Age
Humans
Logistic Models
Placenta / pathology*,  virology*
Pregnancy
Pregnancy Complications, Infectious / epidemiology*
Pregnancy Trimester, Second
Prospective Studies
Grant Support
ID/Acronym/Agency:
HD42100/HD/NICHD NIH HHS

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


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