Ramkripa Raghavan1, Blandine Bustamante Helfrich2, Sandra R Cerda3, Yuelong Ji1, Irina Burd4, Guoying Wang1, Xiumei Hong1, Lingling Fu5, Colleen Pearson5, M Daniele Fallin6, Barry Zuckerman5, Xiaobin Wang7. 1. Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe St, Room E4132, Baltimore, MD, United States. 2. Department of Clinical and Applied Science Education (Pathology), University of the Incarnate Word School of Osteopathic Medicine, San Antonio, TX, United States. 3. Department of Pathology and Laboratory Medicine, Boston Medical Center, Boston, MA, United States. 4. Integrated Research Center for Fetal Medicine, Department of Obstetrics and Gynecology, Johns Hopkins School of Medicine, Baltimore, MD, United States. 5. Department of Pediatrics, Boston University School of Medicine and Boston Medical Center, Boston, MA, United States. 6. Wendy Klag Center for Autism and Developmental Disabilities & Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, 624 N. Broadway, HH 850, Baltimore, MD, 21205, United States. 7. Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe St, Room E4132, Baltimore, MD, United States; Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, United States. Electronic address: xwang82@jhu.edu.
Abstract
INTRODUCTION: Preterm birth (PTB) and in-utero inflammation are recognized risk factors of neurodevelopmental disabilities (NDDs); however, their combined role in NDDs is unknown. We examined the independent and joint association of PTB and placental histological findings with the childhood risk of NDDs (overall and by subgroups including autism spectrum disorder (ASD) and ADHD). METHODS: We analyzed data from the Boston Birth Cohort, where mother-infant pairs were enrolled at birth and followed from birth onwards. Birth outcomes, placental pathology and NDDs were obtained from electronic medical records. Placental pathology was categorized using a standardized classification system proposed by the Amsterdam Placental Workshop Group. RESULTS: PTB (all, including spontaneous, medically indicated) was an independent risk factor for NDDs. Placental histological chorioamnionitis (CA) and PTB additively increased the odds of NDDs (aOR: 2.16, 95% CI: 1.37, 3.39), as well as ADHD (aOR: 2.75, 95% CI: 1.55, 4.90), other developmental disabilities (aOR: 1.96, 95% CI: 1.18, 3.25) and possibly ASD (aOR: 2.31, 95% CI: 0.99, 5.39). The above associations were more pronounced in spontaneous than medically indicated PTB. PTB alone in the absence of CA only had a moderate association with ASD and ADHD. Placental maternal vascular malperfusion alone or in combination with PTB was not associated with the risk of NDDs. DISCUSSION: Our study provided new insights on PTB and NDDs by further considering preterm subtypes and placental histology. We revealed that children of spontaneous PTB along with histological CA were at the highest risk for a spectrum of NDDs.
INTRODUCTION: Preterm birth (PTB) and in-utero inflammation are recognized risk factors of neurodevelopmental disabilities (NDDs); however, their combined role in NDDs is unknown. We examined the independent and joint association of PTB and placental histological findings with the childhood risk of NDDs (overall and by subgroups including autism spectrum disorder (ASD) and ADHD). METHODS: We analyzed data from the Boston Birth Cohort, where mother-infant pairs were enrolled at birth and followed from birth onwards. Birth outcomes, placental pathology and NDDs were obtained from electronic medical records. Placental pathology was categorized using a standardized classification system proposed by the Amsterdam Placental Workshop Group. RESULTS: PTB (all, including spontaneous, medically indicated) was an independent risk factor for NDDs. Placental histological chorioamnionitis (CA) and PTB additively increased the odds of NDDs (aOR: 2.16, 95% CI: 1.37, 3.39), as well as ADHD (aOR: 2.75, 95% CI: 1.55, 4.90), other developmental disabilities (aOR: 1.96, 95% CI: 1.18, 3.25) and possibly ASD (aOR: 2.31, 95% CI: 0.99, 5.39). The above associations were more pronounced in spontaneous than medically indicated PTB. PTB alone in the absence of CA only had a moderate association with ASD and ADHD. Placental maternal vascular malperfusion alone or in combination with PTB was not associated with the risk of NDDs. DISCUSSION: Our study provided new insights on PTB and NDDs by further considering preterm subtypes and placental histology. We revealed that children of spontaneous PTB along with histological CA were at the highest risk for a spectrum of NDDs.
Authors: Yuta Aoki; Yuliya N Yoncheva; Bosi Chen; Tanmay Nath; Dillon Sharp; Mariana Lazar; Pablo Velasco; Michael P Milham; Adriana Di Martino Journal: JAMA Psychiatry Date: 2017-11-01 Impact factor: 21.596
Authors: Jennifer K Straughen; Dawn P Misra; George Divine; Ruchit Shah; Gabriela Perez; Samantha VanHorn; Victoria Onbreyt; Beata Dygulska; Rebecca Schmitt; Sanford Lederman; Pramod Narula; Carolyn M Salafia Journal: Placenta Date: 2017-07-08 Impact factor: 3.481
Authors: Luigi Gagliardi; Franca Rusconi; Monica Da Frè; Giorgio Mello; Virgilio Carnielli; Domenico Di Lallo; Francesco Macagno; Silvana Miniaci; Carlo Corchia; Marina Cuttini Journal: Pediatr Res Date: 2013-03-14 Impact factor: 3.756
Authors: Catherine Limperopoulos; Haim Bassan; Nancy R Sullivan; Janet S Soul; Richard L Robertson; Marianne Moore; Steven A Ringer; Joseph J Volpe; Adré J du Plessis Journal: Pediatrics Date: 2008-04 Impact factor: 7.124
Authors: Jen-Mei Chang; Hui Zeng; Ruxu Han; Ya-Mei Chang; Ruchit Shah; Carolyn M Salafia; Craig Newschaffer; Richard K Miller; Philip Katzman; Jack Moye; Margaret Fallin; Cheryl K Walker; Lisa Croen Journal: BMC Med Inform Decis Mak Date: 2017-12-06 Impact factor: 2.796
Authors: Carolyn M Salafia; Kristen Lyall; Caichen Zhong; Ruchit Shah; Juliette Rando; Bo Park; Theresa Girardi; Cheryl K Walker; Lisa A Croen; M Daniele Fallin; Irva Hertz-Picciotto; Brian K Lee; Rebecca J Schmidt; Heather E Volk; Craig J Newschaffer Journal: BMC Pregnancy Childbirth Date: 2022-06-28 Impact factor: 3.105
Authors: Kirsi S Oldenburg; Lauren A Eaves; Lisa Smeester; Hudson P Santos; T Michael O'Shea; Rebecca C Fry Journal: Placenta Date: 2021-06-18 Impact factor: 3.287
Authors: Imran N Mir; Stormi P White; L Steven Brown; Roy Heyne; Charles R Rosenfeld; Lina F Chalak Journal: Pediatr Res Date: 2020-09-19 Impact factor: 3.756