Correlation between Clinical, Placental Histology and Microbiological Findings in Spontaneous Preterm Births

Garmi, Gali; Okopnik, Marina; Keness, Yoram; Zafran, Noah; Berkowitz, Elad; Salim, Raed

doi:10.1159/000441518

Cited by 9 publications

(6 citation statements)

References 22 publications

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“…Placental abruption has been shown by other studies to be nine times more likely to occur in preterm gestational ages than is in term gestational ages (2.8% versus 0.3%, respectively) [ 29 ]. Still, other studies have shown that placental abruption implicates itself in 5.8% of births occurring before 35 weeks of gestation, with another finding that 50% of women with PTB had “clinical or histological abruption, chorioamnionitis, or both” [ 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

Preterm Delivery; Who Is at Risk?

Kluwgant

Wainstock

Pariente

2021

JCM

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Preterm birth (PTB) is the leading cause of perinatal morbidity and mortality. Adverse effects of preterm birth have a direct correlation with the degree of prematurity, in which infants who are born extremely preterm (24–28 weeks gestation) have the worst outcomes. We sought to determine prominent risk factors for extreme PTB and whether these factors varied between various sub-populations with known risk factors such as previous PTB and multiple gestations. A population-based retrospective cohort study was conducted. Risk factors were examined in cases of extreme PTB in the general population, as well as various sub-groups: singleton and multiple gestations, women with a previous PTB, and women with indicated or induced PTB. A total of 334,415 deliveries were included, of which 1155 (0.35%) were in the extreme PTB group. Placenta previa (OR = 5.8, 95%CI 4.14–8.34, p < 0.001), multiple gestations (OR = 7.7, 95% CI 6.58–9.04, p < 0.001), and placental abruption (OR = 20.6, 95%CI 17.00–24.96, p < 0.001) were the strongest risk factors for extreme PTB. In sub-populations (multiple gestations, women with previous PTB and indicated PTBs), risk factors included placental abruption and previa, lack of prenatal care, and recurrent pregnancy loss. Singleton extreme PTB risk factors included nulliparity, lack of prenatal care, and placental abruption. Placental abruption was the strongest risk factor for extreme preterm birth in all groups, and risk factors did not differ significantly between sub-populations.

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Section: Discussionmentioning

confidence: 99%

Preterm Delivery; Who Is at Risk?

Kluwgant

Wainstock

Pariente

2021

JCM

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“…Numerous studies have suggested that bacterial infections are the cause of PPROM and preterm labor (59)(60)(61). However, until 2014, it was thought that the placenta did not contain its own microbiome.…”

Section: Placental Microbiome?mentioning

confidence: 99%

Immunological Role of the Maternal Uterine Microbiome in Pregnancy: Pregnancies Pathologies and Alterated Microbiota

et al. 2020

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Understanding what happens at the time of embryo implantation has been the subject of significant research. Investigators from many differing fields including maternal fetal medicine, microbiology, genetics, reproductive endocrinology and immunology have all been studying the moment the embryo interacts with the maternal endometrium. A perfect relationship between the uterus and the embryo, mediated by a tightly controlled interaction between the embryo and the endometrium, is required for successful implantation. Any factors affecting this communication, such as altered microbiome may lead to poor reproductive outcomes. Current theories suggest that altered microbiota may trigger an inflammatory response in the endometrium that affects the success of embryo implantation, as inflammatory mediators are tightly regulated during the adhesion of the blastocyst to the epithelial endometrial wall. In this review, we will highlight the various microbiome found during the periconceptual period, the microbiomes interaction with immunological responses surrounding the time of implantation, its effect on implantation, placentation and ultimately maternal and neonatal outcomes.

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“…The placenta has typically been viewed as a sterile organ (5). Yet, it has long been known that bacterial infection of the placental amnion and chorion (15)(16)(17)(18)(19)(20)(21)(22)(23)(24) and/or villous tree (15,18,(25)(26)(27) is associated with preterm labor (16,18,(28)(29)(30)(31)(32)(33)(34), preterm prelabor rupture of the membranes (PPROM) (18,29,30,35,36), histological chorioamnionitis (15-17, 22, 23, 37, 38), clinical chorioamnionitis (15,(36)(37)(38)(39)(40)(41)(42), and congenital infection (26,(43)(44)(45)(46)(47). What is unique about many recent investigations is that they further report detection of a microbiota in placentas from uncomplicated pregnancies at term (1,…”

Section: Introductionmentioning

confidence: 99%

Bacterial profiles of the human placenta from term and preterm deliveries

Theis

Winters

Romero

et al. 2022

Preprint

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Whether the human placenta is a sterile organ is under debate. Yet, infection of the amniotic cavity, including the placenta, is causally linked to preterm birth. This study compares the bacterial profiles of term and preterm placentas through culture and 16S rRNA gene sequencing of the amnion, amnion-chorion interface, subchorion, villous tree, and basal plate, while accounting for patient identity, mode of delivery, presence/absence of labor, and potential background DNA contamination. As no evidence of a placental microbiota in term pregnancy was found, these placentas were considered as controls. Placentas from preterm birth cases were more likely to yield bacterial cultures, and their bacterial DNA profiles were less rich than those of term controls, suggesting the predominance of only a few bacteria. Nevertheless, the bacterial DNA profiles of placentas from preterm cases and term controls were not consistently different. The placentas from preterm cases may often have a microbiota but the bacteria constituting these communities varied among the women. Mode of delivery had a pronounced effect on the bacterial profiles of all sampled levels of the placenta. Specifically, the bacterial DNA profiles of vaginally delivered placentas had higher relative abundances of Finegoldia, Gardnerella, Peptoniphilus, and Prevotella (each a common resident of the vaginal microbiota) than the profiles of cesarean-delivered placentas. Collectively, these data indicate that there is a not a placental microbiota in normal term pregnancy, and that although the placentas of some preterm cases were populated by bacteria, the identities of these bacteria varied among women delivering preterm.

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Correlation between Clinical, Placental Histology and Microbiological Findings in Spontaneous Preterm Births

Cited by 9 publications

References 22 publications

Preterm Delivery; Who Is at Risk?

Preterm Delivery; Who Is at Risk?

Immunological Role of the Maternal Uterine Microbiome in Pregnancy: Pregnancies Pathologies and Alterated Microbiota

Bacterial profiles of the human placenta from term and preterm deliveries

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