Blandine Bustamante Helfrich1, Nymisha Chilukuri2, Huan He3, Sandra R Cerda4, Xiumei Hong5, Guoying Wang5, Colleen Pearson6, Irina Burd7, Xiaobin Wang8. 1. Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Department of Clinical and Applied Science Education (Pathology), University of the Incarnate Word School of Osteopathic Medicine, San Antonio, TX, United States. 2. Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, United States. Electronic address: nchiluk1@jhmi.edu. 3. Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Center for Health Policy and Governance, School of Public Administration, Southwestern University of Finance and Economics, Chengdu, Sichuan, China. Electronic address: hhe7@jhu.edu. 4. Department of Pathology and Laboratory Medicine, Boston Medical Center, Boston, MA, United States. 5. Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States. 6. Department of Pediatrics, Boston University School of Medicine and Boston Medical Center, Boston, MA, United States. 7. Integrated Research Center for Fetal Medicine, Department of Obstetrics and Gynecology, Johns Hopkins School of Medicine, Baltimore, MD, United States. 8. Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, United States. Electronic address: xwang82@jhu.edu.
Abstract
INTRODUCTION: The associations of maternal conditions, before or during pregnancy, with placental lesions have not been adequately studied in populations. METHODS: In the Boston Birth Cohort, we evaluated associations between three maternal medical conditions (hypertensive disorders [HDs], gestational/pre-gestational diabetes and obesity), and placental histological findings, using a standardized classification system proposed by the Amsterdam Placental Workshop Group. Placental pathology diagnoses and clinical data from 3074 mothers with clinical indications who delivered singleton live births at the Boston Medical Center between October 1998 and November 2013 were evaluated. Associations between each maternal condition and maternal vascular malperfusion (MVM) of the placental bed and its standardized subgroups were examined using multivariate logistic and multinomial regressions. RESULTS: Women with HDs (chronic hypertension, eclampsia, preeclampsia, HELLP syndrome) had significantly increased odds of MVM lesions when compared to women with no HD (aOR 2.08 95% CI 1.74-2.50), after adjusting for demographics, substance use, diabetes and body mass index. No significant differences in frequencies or aORs were seen in women with and without diabetes, or across body mass index categories. Co-morbid condition patterns that included HDs were more likely to be associated with MVM than those without. DISCUSSION: Using a standardized classification system, we showed that MVM is strongly and specifically associated with maternal HDs, but not other maternal conditions. Additional studies are needed to confirm and validate our findings, and evaluate the role of maternal vascular lesions of the placental bed in relation to postnatal growth and development of the offspring and effect modifiers.
INTRODUCTION: The associations of maternal conditions, before or during pregnancy, with placental lesions have not been adequately studied in populations. METHODS: In the Boston Birth Cohort, we evaluated associations between three maternal medical conditions (hypertensive disorders [HDs], gestational/pre-gestational diabetes and obesity), and placental histological findings, using a standardized classification system proposed by the Amsterdam Placental Workshop Group. Placental pathology diagnoses and clinical data from 3074 mothers with clinical indications who delivered singleton live births at the Boston Medical Center between October 1998 and November 2013 were evaluated. Associations between each maternal condition and maternal vascular malperfusion (MVM) of the placental bed and its standardized subgroups were examined using multivariate logistic and multinomial regressions. RESULTS:Women with HDs (chronic hypertension, eclampsia, preeclampsia, HELLP syndrome) had significantly increased odds of MVM lesions when compared to women with no HD (aOR 2.08 95% CI 1.74-2.50), after adjusting for demographics, substance use, diabetes and body mass index. No significant differences in frequencies or aORs were seen in women with and without diabetes, or across body mass index categories. Co-morbid condition patterns that included HDs were more likely to be associated with MVM than those without. DISCUSSION: Using a standardized classification system, we showed that MVM is strongly and specifically associated with maternal HDs, but not other maternal conditions. Additional studies are needed to confirm and validate our findings, and evaluate the role of maternal vascular lesions of the placental bed in relation to postnatal growth and development of the offspring and effect modifiers.
Authors: Eliana M Wendland; Maria Regina Torloni; Maicon Falavigna; Janet Trujillo; Maria Alice Dode; Maria Amélia Campos; Bruce B Duncan; Maria Inês Schmidt Journal: BMC Pregnancy Childbirth Date: 2012-03-31 Impact factor: 3.007
Authors: Lisa M Bebell; Kalynn Parks; Mylinh H Le; Joseph Ngonzi; Julian Adong; Adeline A Boatin; Ingrid V Bassett; Mark J Siedner; Alison D Gernand; Drucilla J Roberts Journal: J Infect Dis Date: 2021-12-08 Impact factor: 5.226
Authors: Daniel Tairy; Eran Weiner; Letizia Schreiber; Hadas Miremberg; Liat Gindes; Roni Hochman; Jacob Bar; Michal Kovo Journal: Reprod Sci Date: 2021-04-06 Impact factor: 2.924
Authors: Xiumei Hong; Avi Z Rosenberg; Boyang Zhang; Elizabeth Binns-Roemer; Victor David; Yiming Lv; Rebecca C Hjorten; Kimberly J Reidy; Teresa K Chen; Guoying Wang; Yuelong Ji; Claire L Simpson; Robert L Davis; Jeffrey B Kopp; Xiaobin Wang; Cheryl A Winkler Journal: Am J Kidney Dis Date: 2020-12-22 Impact factor: 11.072
Authors: Nadia M Ikumi; Thokozile R Malaba; Komala Pillay; Marta C Cohen; Hlengiwe P Madlala; Mushi Matjila; Dilly Anumba; Landon Myer; Marie-Louise Newell; Clive M Gray Journal: AIDS Date: 2021-04-01 Impact factor: 4.177