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

IF 2.5 3区医学 Q3 IMMUNOLOGY

American Journal of Reproductive Immunology Pub Date : 2024-08-13 DOI:10.1111/aji.13914

Aman Zheng, Yushuang Zheng, Donglu Li, Xinran Li, Xia Tong, Fan Wang

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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.

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自身免疫性结缔组织病孕妇的胎盘病理特征和围产期结果

简介我们旨在研究系统性红斑狼疮（SLE）、抗磷脂抗体综合征（APS）和未分化结缔组织病（UCTD）等ACTD孕妇的围产期结局与胎盘病理特征之间的关联：纳入系统性红斑狼疮（44 例）、抗磷脂抗体综合征（45 例）和未分化结缔组织病（45 例）的胎盘组织，并将 2015 年 9 月至 2021 年 3 月期间同期分娩的胎盘作为对照组（46 例）。胎盘组织病理学采用《人类胎盘病理学手册》进行评估，并根据阿姆斯特丹共识框架进行分类：与对照组相比，系统性红斑狼疮孕妇的剖宫产率（61.40%）、早产率（24.56%）和SGA率（26.32%）较高（分别为P = 0.008、P = 0.005和P = 0.000）。系统性红斑狼疮组血管灌注不良、炎症免疫性病变和其他胎盘病变的发生率分别为47.73%、56.82%和63.64%，均高于对照组（分别为P = 0.000、P = 0.000和P = 0.006）。同时，与对照组相比，APS组（42.22%，P = 0.004）和UCTD组（37.78%，P = 0.007）炎症免疫性病变和血管灌注不良的发生率均有所增加：结论：系统性红斑狼疮似乎增加了围产期各种不良结局的风险。我们确定大多数患有ACTD的妇女胎盘组织病理学风险升高，包括血管发育不良、血管灌注不良和炎症免疫性病变。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Reproductive Immunology 医学-免疫学

CiteScore

6.20

自引率

5.60%

发文量

314

审稿时长

2 months

期刊介绍： The American Journal of Reproductive Immunology is an international journal devoted to the presentation of current information in all areas relating to Reproductive Immunology. The journal is directed toward both the basic scientist and the clinician, covering the whole process of reproduction as affected by immunological processes. The journal covers a variety of subspecialty topics, including fertility immunology, pregnancy immunology, immunogenetics, mucosal immunology, immunocontraception, endometriosis, abortion, tumor immunology of the reproductive tract, autoantibodies, infectious disease of the reproductive tract, and technical news.