PMID- 25183023
OWN - NLM
STAT- MEDLINE
DCOM- 20160629
LR  - 20211021
IS  - 1476-4954 (Electronic)
IS  - 1476-7058 (Print)
IS  - 1476-4954 (Linking)
VI  - 28
IP  - 13
DP  - 2015 Sep
TI  - Placental lesions associated with acute atherosis.
PG  - 1554-62
LID - 10.3109/14767058.2014.960835 [doi]
AB  - OBJECTIVE: Acute atherosis is a lesion of the spiral arteries characterized by 
      fibrinoid necrosis of the vessel wall, an accumulation of fat-containing 
      macrophages, and a mononuclear perivascular infiltrate, which can be found in 
      patients with preeclampsia, fetal death, small-for-gestational age, spontaneous 
      preterm labor/premature prelabor rupture of membrane, and spontaneous 
      mid-trimester abortion. This lesion is thought to decrease blood flow to the 
      intervillous space which may lead to other vascular lesions of the placenta. The 
      objective of this study was to test whether there is an association between acute 
      atherosis and placental lesions that are consistent with maternal vascular 
      underperfusion (MVU), amniotic fluid infection (AFI), fetal vascular 
      thrombo-occlusive disease (FVTOD) or chronic inflammation. MATERIAL AND METHODS: 
      A retrospective cohort study of pregnant women who delivered between July 1998 
      and July 2014 at Hutzel Women's Hospital/Detroit Medical Center was conducted 
      examine 16 457 placentas. The frequency of placenta lesions (diagnosed using the 
      criteria of the Perinatal Section of the Society for Pediatric Pathology) was 
      compared between pregnancies with and without acute atherosis. RESULTS: Among 
      16 457 women who were enrolled, 10.2% (1671/16 457) were excluded, leaving 14 786 
      women who contributed data for analysis. Among them, the prevalence of acute 
      atherosis was 2.2% (326/14 786). Women with acute atherosis were more than six 
      times as likely as those without to have placental lesions consistent with 
      maternal underperfusion (adjusted odds ratio - aOR: 6.7; 95% CI 5.2-8.6). To a 
      lesser degree, acute atherosis was also associated with greater risks of having 
      either lesions consistent with FVTOD (aOR 1.7; 95% CI 1.2-2.3) or chronic 
      chorioamnionitis (aOR 1.9; 95% CI 1.3-3), but not with other chronic inflammatory 
      lesions, after adjusting for gestational age at delivery. In contrast, women with 
      acute atherosis were 60% less likely to have lesions consistent with AFI, 
      adjusting for gestational age at delivery (aOR 0.4; 95% CI 0.3-0.5). CONCLUSIONS: 
      Acute atherosis is associated with increased risks of having placental lesions 
      consistent with MVU, and to a lesser extent, chronic chorioamnionitis and those 
      consistent with FVTOD.
FAU - Kim, Yeon Mee
AU  - Kim YM
AD  - a Department of Pathology , Haeundae Paik Hospital, Inje University College of 
      Medicine , Busan , Korea .
FAU - Chaemsaithong, Piya
AU  - Chaemsaithong P
FAU - Romero, Roberto
AU  - Romero R
FAU - Shaman, Majid
AU  - Shaman M
FAU - Kim, Chong Jai
AU  - Kim CJ
FAU - Kim, Jung-Sun
AU  - Kim JS
FAU - Qureshi, Faisal
AU  - Qureshi F
FAU - Jacques, Suzanne M
AU  - Jacques SM
FAU - Ahmed, Ahmed I
AU  - Ahmed AI
FAU - Chaiworapongsa, Tinnakorn
AU  - Chaiworapongsa T
FAU - Hassan, Sonia S
AU  - Hassan SS
FAU - Yeo, Lami
AU  - Yeo L
FAU - Korzeniewski, Steven J
AU  - Korzeniewski SJ
LA  - eng
GR  - HHSN275201300006C/HD/NICHD NIH HHS/United States
GR  - ZIA HD002400-23/Intramural NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Intramural
DEP - 20141030
PL  - England
TA  - J Matern Fetal Neonatal Med
JT  - The journal of maternal-fetal & neonatal medicine : the official journal of the 
      European Association of Perinatal Medicine, the Federation of Asia and Oceania 
      Perinatal Societies, the International Society of Perinatal Obstetricians
JID - 101136916
SB  - IM
MH  - Acute Disease
MH  - Adult
MH  - Chorioamnionitis/epidemiology/pathology
MH  - Female
MH  - Humans
MH  - Infant, Newborn
MH  - Inflammation/epidemiology/pathology
MH  - Necrosis
MH  - Placenta/*blood supply/*pathology
MH  - Placenta Diseases/epidemiology/*pathology
MH  - Pre-Eclampsia/epidemiology/pathology
MH  - Pregnancy
MH  - Pregnancy Complications, Cardiovascular/epidemiology/pathology
MH  - Pregnancy Complications, Infectious/epidemiology/pathology
MH  - Retrospective Studies
MH  - Uterine Artery/*pathology
PMC - PMC4416076
MID - NIHMS638211
OTO - NOTNLM
OT  - Amniotic fluid infection
OT  - chronic chorioamnionitis
OT  - chronic villitis
OT  - fetal vascular thrombo-occlusive disease
OT  - ischemic placental disease
OT  - maternal anti-fetal rejection
OT  - maternal underperfusion
OT  - pregnancy
COIS- Declaration of Interest: The authors declare no declaration of interest.
EDAT- 2014/09/04 06:00
MHDA- 2016/06/30 06:00
PMCR- 2016/09/01
CRDT- 2014/09/04 06:00
PHST- 2014/09/04 06:00 [entrez]
PHST- 2014/09/04 06:00 [pubmed]
PHST- 2016/06/30 06:00 [medline]
PHST- 2016/09/01 00:00 [pmc-release]
AID - 10.3109/14767058.2014.960835 [doi]
PST - ppublish
SO  - J Matern Fetal Neonatal Med. 2015 Sep;28(13):1554-62. doi: 
      10.3109/14767058.2014.960835. Epub 2014 Oct 30.