Chronic chorioamnionitis is the most common placental lesion in late preterm birth

Lee, J.; Kim, J.-S.; Park, Je Won; Park, C.-W.; Park, J.S.; Jun, Jong Kwan; Yoon, Bo Hyun

doi:10.1016/j.placenta.2013.04.014

Cited by 92 publications

(85 citation statements)

References 47 publications

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“…The placental lesions associated with maternal anti-fetal rejection are chronic chorioamnionitis [11,13,14,[20][21][22]117], villitis of unknown etiology [19,21,23,24,118,119] and chronic deciduitis with plasma cells [21] as evidenced by the presence of cell-and antibody-mediated immune responses. For an in-depth appraisal on this topic, please refer to the review by Kim et al [25].…”

Section: The Role Of Cxcr3 In Transplant Rejectionmentioning

confidence: 99%

“…A breakdown of maternal-fetal tolerance has been implicated in the mechanisms of disease responsible for a subset of recurrent pregnancy loss [10], fetal death [11,12], preterm labor [13][14][15][16][17][18], preterm prelabor rupture of the membranes (preterm PROM) [15] and other obstetrical complications [19][20][21][22][23][24].…”

Section: Introductionmentioning

confidence: 99%

“…The most common placental pathologic lesion in late spontaneous preterm labor and birth is chronic chorioamnionitis [22,25], which is considered a manifestation of maternal anti-fetal rejection. In this lesion, maternal CD8 + T cells infiltrate the chorioamniotic membranes; thus, lymphocytes from the host (i.e.…”

Section: Introductionmentioning

confidence: 99%

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Chronic inflammatory lesions of the placenta are associated with an up-regulation of amniotic fluid CXCR3: A marker of allograft rejection

Maymon

Romero

Bhatti

et al. 2018

Journal of Perinatal Medicine

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Objective: The objective of this study is to determine whether the amniotic fluid (AF) concentration of soluble CXCR3 and its ligands CXCL9 and CXCL10 changes in patients whose placentas show evidence of chronic chorioamnionitis or other placental lesions consistent with maternal anti-fetal rejection. Methods: This retrospective case-control study included 425 women with (1) preterm delivery (n = 92); (2) term in labor (n = 68); and (3) term not in labor (n = 265). Amniotic fluid CXCR3, CXCL9 and CXCL10 concentrations were determined by ELISA. Results: (1) Amniotic fluid concentrations of CXCR3 and its ligands CXCL9 and CXCL10 are higher in patients with preterm labor and maternal anti-fetal rejection lesions than in those without these lesions [CXCR3: preterm labor and delivery with maternal anti-fetal rejection placental lesions (median, 17.24 ng/mL; IQR, 6.79-26.68) vs. preterm labor and delivery without these placental lesions (median 8.79 ng/mL; IQR, 4.98-14.7; P = 0.028)]; (2) patients with preterm labor and chronic chorioamnionitis had higher AF concentrations of CXCL9 and CXCL10, but not CXCR3, than those without this lesion [CXCR3: preterm labor with chronic chorioamnionitis (median, 17.02 ng/mL; IQR, 5.57-26.68) vs. preterm labor without chronic chorioamnionitis (median, 10.37 ng/mL; IQR 5.01-17.81; P = 0.283)]; (3) patients with preterm labor had a significantly higher AF concentration of CXCR3 than those in labor at term regardless of the presence or absence of placental lesions. Conclusion: Our findings support a role for maternal antifetal rejection in a subset of patients with preterm labor.

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Section: The Role Of Cxcr3 In Transplant Rejectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Chronic inflammatory lesions of the placenta are associated with an up-regulation of amniotic fluid CXCR3: A marker of allograft rejection

Maymon

Romero

Bhatti

et al. 2018

Journal of Perinatal Medicine

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“…CHORIO is the most common abnormality found in placentas from very preterm infants, and is a principle cause of preterm birth (221,223,224,232). Preterm birth, or delivery prior to 37 weeks' gestation, is the primary cause of perinatal morbidity and mortality in developed countries and impacts approximately 12% of all deliveries in the US (233).…”

Section: Chorioamnionitismentioning

confidence: 99%

“…Indeed, recent neuroimaging studies of preterm infants with detailed placental histology and neonatal neuroimaging at term equivalent age show histological CHORIO is an independent antenatal risk factor for preterm brain injury (247). Additionally, placental abnormalities are an independent risk factor in the pathogenesis of perinatal stroke (223,224,(248)(249)(250) (221,(254)(255)(256)(257)(258)(259)(260)(261). In the absence of other risk factors, the cytokine milieu of CHORIO can facilitate a hypercoaguable state or cause direct thromboembolism to the fetal brain (260,262).…”

Section: Chorioamnionitismentioning

confidence: 99%

The Unifying Effects of Maternal-Placental-Fetal Axis Dysregulation on Neurodevelopment Following Infectious and Toxic In Utero Insults

Yellowhair¹,

Oppong²,

Maxwell³

et al. 2017

MRAJ

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Homeostasis during pregnancy and in the in utero environment is essential for prenatal development. Prenatal maturation is hallmarked by an orchestrated and rigorous developmental program characterized by critical cascades in multiple organ systems. During these critical periods of development, however, potential vulnerability to injury exists throughout pregnancy. Indeed, the developing central nervous system (CNS) is extremely vulnerable to environmental insults throughout the entirety of gestation. These insults can adversely affect the developing brain and spinal cord, and permanently alter the neurodevelopmental trajectory. Specifically, in utero insults and dysregulation of the maternal-placentalfetal axis can change molecular, cellular, structural, and functional development of the CNS, culminating in adverse outcomes and neurological disorders throughout postnatal life. In this review, we will discuss common infectious and toxin-induced in utero insults that have recently garnered attention, including Zika virus, prenatal opioid and alcohol exposure, and chorioamnionitis. The goals are to identify common pathophysiological mechanisms, to emphasize the urgent need for new diagnostic tools, and to promote a broader understanding of the diverse array of neurological outcomes presenting in these children throughout their lifespan. With an increasing number of infants exposed to in utero infections and toxins, and the expanding public health awareness of the consequences of Zika infection, the opioid crisis, alcohol consumption during pregnancy, and the frequency of preterm birth in the United States, familiarity with the underlying mechanisms of each of these insults is paramount to improve the diagnosis and treatment for this exceedingly vulnerable patient population.

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Placental Disorders of Uncertain Etiology

Katzman¹

2021

Benirschke's Pathology of the Human Placenta

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Chronic chorioamnionitis is the most common placental lesion in late preterm birth

Cited by 92 publications

References 47 publications

Chronic inflammatory lesions of the placenta are associated with an up-regulation of amniotic fluid CXCR3: A marker of allograft rejection

Chronic inflammatory lesions of the placenta are associated with an up-regulation of amniotic fluid CXCR3: A marker of allograft rejection

The Unifying Effects of Maternal-Placental-Fetal Axis Dysregulation on Neurodevelopment Following Infectious and Toxic In Utero Insults

Placental Disorders of Uncertain Etiology

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