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Trophoblast inclusions and pregnancy characteristics

Citation

Kliman, Harvey; Firestein, Morgan; Odendaal, Hein (2022), Trophoblast inclusions and pregnancy characteristics, Dryad, Dataset, https://doi.org/10.5061/dryad.9zw3r22gj

Abstract

Objective

Trophoblast inclusions—cross sections of abnormal trophoblast bilayer infoldings— have previously been associated with aneuploidy, placenta accreta, and prematurity. This study was conducted to establish the relationship between trophoblast inclusions and a range of placental, pregnancy, and birth outcomes in a patient population with high smoking and alcohol exposure. Specifically, we sought to evaluate the association between the presence of trophoblast inclusions and 1) three primary birth outcomes: full-term birth, preterm birth, and stillbirth; 2) gestational age at delivery; and 3) specific placental pathologies.

Methods

Two slides containing chorionic villi were evaluated from 589 placentas that were collected from Stellenbosch University in Cape Town, South Africa as part of the prospective, multicenter cohort Safe Passage Study of the Prenatal Alcohol and SIDS and Stillbirth Network. The subsample included 307 full-term live births, 212 preterm live births, and 70 stillbirths.

Results

We found that the odds of identifying at least one trophoblast inclusion across two slides of chorionic villi was significantly higher for placentas from preterm compared to term liveborn deliveries (OR = 1.74; 95% CI: 1.22, 2.49, = 0.002), with an even greater odds ratio for placentas from stillborn compared to term liveborn deliveries (OR = 4.95; 95% CI: 2.78, 8.80, p < 0.001). Gestational age at delivery was inversely associated with trophoblast inclusion frequency. Trophoblast inclusions were significantly associated with small for gestational age birthweight, induction of labor, villous edema, placental infarction, and inflammation of the chorionic plate.

Conclusions

The novel associations that we report warrant further investigation in order to understand the complex network of biological mechanisms through which the factors that lead to trophoblast inclusions may influence or reflect the trajectory and health of a pregnancy. Ultimately, this line of research may provide critical insights that could inform both clinical and research applications.

Funding

Eunice Kennedy Shriver National Institute of Child Health and Human Development, Award: U01HD055154

Eunice Kennedy Shriver National Institute of Child Health and Human Development, Award: U01HD045935

Eunice Kennedy Shriver National Institute of Child Health and Human Development, Award: U01HD055155

Eunice Kennedy Shriver National Institute of Child Health and Human Development, Award: U01HD045991

National Institute on Alcohol Abuse and Alcoholism, Award: U01AA016501

Eunice Kennedy Shriver National Institute of Child Health and Human Development, Award: K99HD103910

Reproductive and Placental Research Unit, Yale University