Villitis of unknown etiology and chronic deciduitis are not associated with human papilloma virus and enterovirus infection

Feist, Henning; Hussein, Kais; Stucki-Koch, Angelika; Wohlschlaeger, Jeremias; Hager, Thomas; Blocker, T G; Heim, Albert

doi:10.1007/s00428-020-02765-0

Cited by 6 publications

(9 citation statements)

References 46 publications

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“…The study characteristics, PTB definition, placental histopathology classification system, range of infective organisms, and sample size are summarized in Table 1 . The majority (56.5%, 13/23) of studies examined the association between bacterial infection and placental histopathology in PTB [ 30 , 31 , 35 – 39 , 41 , 44 , 46 – 49 ], six studies (26%) examined viral infection [ 29 , 32 , 33 , 42 , 45 , 50 ], and four studies (17%) examined studied parasites [ 28 , 34 , 40 , 43 ].…”

Section: Resultsmentioning

confidence: 99%

“…Seven studies used their own definitions of histological chorioamnionitis [ 36 – 38 , 41 , 42 , 47 , 48 , 50 ] and three malaria studies [ 28 , 40 , 43 ] used four classifications [ 61 ]. Evidence of reporting of the severity of placental histopathological abnormality was limited to eight (34.8%) of studies [ 28 , 32 , 35 , 39 , 44 , 47 – 49 ].…”

Section: Resultsmentioning

confidence: 99%

“…For studies targeting human immunodeficiency virus (HIV) infection, two studies used an enzyme linked immunosorbent assay (ELISA) as a diagnostic test [ 33 , 42 ], while another two studies did not mention the diagnostic methods [ 29 , 45 ]. In another two studies that targeted viral infection, polymerase chain reaction (PCR) was performed to detect adenovirus, human papilloma virus (HPV) and enterovirus [ 32 , 50 ]. Two of three malaria studies confirmed infection by peripheral blood films, placental blood microscopy, and Loop-mediated isothermal application (LAMP) [ 28 , 40 ] but the histopathological detection of malaria parasites and pigment in placenta was used in all three malaria studies [ 28 , 40 , 43 ].…”

Section: Resultsmentioning

confidence: 99%

“…Feist et al . did not find an association between HPV and enteroviruses in the development of placental histological abnormalities (i.e., villitis of unknown origin and chronic deciduitis) in both preterm and term pregnancies [ 32 ]. Tsekoura et al .…”

Section: Resultsmentioning

confidence: 99%

“…Contamination of the placenta and membranes can occur due to PPROM or during passage through the vagina, or skin during Caesarean section, and sequencing methods do not distinguish between viable and non-viable bacteria [ 74 , 75 ]. Some authors in this review indicated that the role of infection in PTB may be underestimated due to limitations in the diagnostic methods [ 31 , 47 , 49 ], the difficulty of distinguishing between colonisation and contamination [ 35 ], and decreased bacterial abundance due to antibiotic treatment prior to tissue sampling [ 32 , 34 , 35 ]. No manuscript in this review reached the ideal “gold standard” to link the pathogen and placental histopathology of “amniotic fluid culture/polymerase chain reaction (PCR) and placental pathology” [ 70 ].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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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.

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