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Placental lesions associated with acute atherosis.
J Matern Fetal Neonatal Med. 2015 Sep; 28(13):1554-62.JM

Abstract

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.

Authors+Show Affiliations

a Department of Pathology , Haeundae Paik Hospital, Inje University College of Medicine , Busan , Korea .No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Intramural

Language

eng

PubMed ID

25183023

Citation

Kim, Yeon Mee, et al. "Placental Lesions Associated With Acute Atherosis." 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, vol. 28, no. 13, 2015, pp. 1554-62.
Kim YM, Chaemsaithong P, Romero R, et al. Placental lesions associated with acute atherosis. J Matern Fetal Neonatal Med. 2015;28(13):1554-62.
Kim, Y. M., Chaemsaithong, P., Romero, R., Shaman, M., Kim, C. J., Kim, J. S., Qureshi, F., Jacques, S. M., Ahmed, A. I., Chaiworapongsa, T., Hassan, S. S., Yeo, L., & Korzeniewski, S. J. (2015). Placental lesions associated with acute atherosis. 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, 28(13), 1554-62. https://doi.org/10.3109/14767058.2014.960835
Kim YM, et al. Placental Lesions Associated With Acute Atherosis. J Matern Fetal Neonatal Med. 2015;28(13):1554-62. PubMed PMID: 25183023.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Placental lesions associated with acute atherosis. AU - Kim,Yeon Mee, AU - Chaemsaithong,Piya, AU - Romero,Roberto, AU - Shaman,Majid, AU - Kim,Chong Jai, AU - Kim,Jung-Sun, AU - Qureshi,Faisal, AU - Jacques,Suzanne M, AU - Ahmed,Ahmed I, AU - Chaiworapongsa,Tinnakorn, AU - Hassan,Sonia S, AU - Yeo,Lami, AU - Korzeniewski,Steven J, Y1 - 2014/10/30/ PY - 2014/9/4/entrez PY - 2014/9/4/pubmed PY - 2016/6/30/medline KW - Amniotic fluid infection KW - chronic chorioamnionitis KW - chronic villitis KW - fetal vascular thrombo-occlusive disease KW - ischemic placental disease KW - maternal anti-fetal rejection KW - maternal underperfusion KW - pregnancy SP - 1554 EP - 62 JF - 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 JO - J. Matern. Fetal. Neonatal. Med. VL - 28 IS - 13 N2 - 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. SN - 1476-4954 UR - https://www.unboundmedicine.com/medline/citation/25183023/Placental_lesions_associated_with_acute_atherosis_ L2 - http://www.tandfonline.com/doi/full/10.3109/14767058.2014.960835 DB - PRIME DP - Unbound Medicine ER -