Placental histopathology in preterm birth with confirmed maternal infection: A systematic literature review

Abstract

Four in five neonatal deaths of preterm births occur in low and middle income countries and placental histopathology examination can help clarify the pathogenesis. Infection is known to play a significant role in preterm birth. The aim of this systematic review is to explore the association between placental histopathological abnormality and preterm birth in the presence of confirmed infection. PubMed/Medline, Scopus, Web of Science and Embase were searched using the keywords related to preterm birth, placental histopathology and infection. Titles and abstracts were screened and the full texts of eligible articles were reviewed to extract and summarise data. Of 1529 articles, only 23 studies (13 bacterial, 6 viral and 4 parasitic) were included, and they used 7 different gestational age windows, and 20 different histopathological classification systems, precluding data pooling. Despite this, histopathological chorioamnionitis, and funisitis (when examined) were commonly observed in preterm birth complicated by confirmed bacterial or viral, but not parasitic, infection. The presence of malaria parasites but not pigment in placenta was reported to increase the risk of PTB, but this finding was inconclusive. One in three studies were conducted in low and middle income countries. An array of: definitions of preterm birth subgroups, histological classification systems, histopathologic abnormalities and diagnostic methods to identify infections were reported in this systematic review. Commitment to using standardised terminology and classification of histopathological abnormalities associated with infections is needed to identify causality and potential treatment of preterm birth. Studies on preterm birth needs to occur in high burden countries and control for clinical characteristics (maternal, fetal, labor, and placental) that may have an impact on placental histopathological abnormalities.

Contribution of genetic factors to high rates of neonatal hyperbilirubinaemia on the Thailand-Myanmar border

“…In conclusion, the high risk of NH in the first week of life in this cohort of Karen and Burman neonates was mainly a result of lower EGA. This has many aetiologies but, in low resource settings, infections are an important and preventable cause [47]. For neonates with EGA�38 weeks, some actionable risk factors were identified such as excess maternal weight gain [48], prolonged rupture of membranes, trauma at birth and neonatal sepsis.…”

Type VII Aplasia Cutis Congenita in Neonates Related to Maternal HBV Infection? Case Report and Literature Review

“… 25 The main histological finding of viral infected placentas is chorioamnionitis which could present as fibrinoid deposition with villous degeneration. 26 Some viri could cause thrombotic pathology in placenta, 27 which could potentially lead to ACC. However, the relationship between HBV infection and ACC, as well as the pathogenic process of ACC, requires further investigation.…”

Does Precision-Based Medicine Hold the Promise of a New Approach to Predicting and Treating Spontaneous Preterm Birth?

“…This triggers thrombin-stimulated myometrial contractility through protease-activated receptors PAR1 and PAR3 as well as degradation of the extracellular matrix, causing chorioamniotic membrane compromise [28]. Aside from PET, at a microscopic level, shallow invasion of the decidua, umbilical chorionic vasculitis and villitis and other decidual vascular abnormalities are also placental findings associated with infective PTB [29,30]. Though inflammatory pathways are involved in other forms of spontaneous PTL, they do not always result in histological changes in placenta.…”