Placental Pathologic Features and Perinatal Outcomes in Pregnant Woman With Autoimmune Connective Tissue Disease

• Published in: American journal of reproductive immunology (1989) Vol. 92; no. 2; pp. e13914 - n/a
• Main Authors: Zheng, Aman, Zheng, Yushuang, Li, Donglu, Li, Xinran, Tong, Xia, Wang, Fan
• Format: Journal Article
• Language: English
• Published: Denmark Wiley Subscription Services, Inc 01-08-2024
• Subjects: Adult; Antiphospholipid antibodies; antiphospholipid antibody syndrome; Antiphospholipid Syndrome - immunology; Antiphospholipid Syndrome - pathology; Cesarean Section; Connective tissue diseases; Connective Tissue Diseases - immunology; Connective Tissue Diseases - pathology; Female; Histopathology; Humans; Infant, Newborn; Inflammation; Lesions; Lupus Erythematosus, Systemic - pathology; perinatal outcomes; Placenta; Placenta - immunology; Placenta - pathology; placental pathology; Pregnancy; Pregnancy Complications - immunology; Pregnancy Outcome; Premature Birth; Systemic lupus erythematosus; undifferentiated connective tissue disease; Undifferentiated Connective Tissue Diseases - immunology; Undifferentiated Connective Tissue Diseases - pathology; undifferentiated connective tissue disease; placental pathology; systemic lupus erythematosus; perinatal outcomes; antiphospholipid antibody syndrome
• ISSN: 1046-7408; 1600-0897; 1600-0897
• DOI: 10.1111/aji.13914

ABSTRACT
Introduction
We aimed to investigate the association between perinatal outcomes and placental pathological features in pregnant women with ACTD, including systemic lupus erythematosus (SLE), antiphospholipid antibody syndrome (APS), and undifferentiated connective tissue disease (UCTD).
Materials and Methods
Placental tissue from SLE (n = 44), APS (n = 45), and UCTD (n = 45) were included, and contemporaneous deliveries of placenta were served as a control group (n = 46) between September 2015 and March 2021. The placental histopathology was evaluated using the Manual of Human Placental Pathology and classified according to the Amsterdam consensus framework.
Results
SLE pregnant women have a higher rate of cesarean section (61.40%), premature birth (24.56%), and SGA (26.32%) when compared to control group (p = 0.008, p = 0.005, and p = 0.000, respectively). The rate of vascular malperfusion, inflammatory‐immune lesions, and other placental lesions in the SLE group was 47.73%, 56.82%, and 63.64%, which were higher than the control group (p = 0.000, p = 0.000, and p = 0.006, respectively). In the meantime, the incidence of inflammatory‐immune lesions in the APS group (42.22%, p = 0.004) and vascular malperfusion in the UCTD group (37.78%, p = 0.007) were increased when compared to the control group.
Conclusions
SLE appeared to confer increased risk for a wide range of adverse perinatal outcomes. We determined elevated placental histopathology risk for most women with ACTD, including vascular maldevelopment, vascular malperfusion, and inflammatory‐immune lesions.