Placenta最新文献

{"title":"Maternal body composition and the placental-fetal unit under maternal high-fat feeding partially improve by metformin treatment or lifestyle interventions during pregnancy in a mouse model","authors":"Tobias Kretschmer ,&nbsp;Eva-Maria Turnwald ,&nbsp;Antje Thiele ,&nbsp;Ciara Kallage ,&nbsp;Lena Neweling ,&nbsp;Merlin Kammerer ,&nbsp;Ruth Janoschek ,&nbsp;Peter Zentis ,&nbsp;Marion Handwerk ,&nbsp;Maria Wohlfarth ,&nbsp;Simone Kalis ,&nbsp;Eva Nüsken ,&nbsp;Kai-Dietrich Nüsken ,&nbsp;Inga Bae-Gartz ,&nbsp;Angela Köninger ,&nbsp;Alexandra Gellhaus ,&nbsp;Dirk Gründemann ,&nbsp;Eva Hucklenbruch-Rother ,&nbsp;Jörg Dötsch ,&nbsp;Miguel A. Alejandre Alcazar ,&nbsp;Sarah Appel","doi":"10.1016/j.placenta.2025.09.016","DOIUrl":"10.1016/j.placenta.2025.09.016","url":null,"abstract":"<div><h3>Introduction</h3><div>Studies showed that metabolic imbalances during pregnancy in obesity impair the maternal-fetal axis, resulting in fetal growth disturbances with higher risk later in life. Since research has linked many of maternal and fetal sequelae to placental dysfunction, we tested if treatment with an anti-diabetic drug (metformin) or lifestyle interventions improve maternal body weight, placental status or fetal growth.</div></div><div><h3>Methods</h3><div>Mice were either fed a control or high-fat diet. After mating, high-fat diet mice were split into 4 subgroups, 1 received no intervention while the other 3 received either metformin treatment, a nutritional intervention (NI) or an exercise intervention (RUN). At gestational day 15.5, mice were sacrificed.</div></div><div><h3>Results</h3><div>All interventions improved body weight of high-fat diet dams, but only NI and RUN maintained fetal growth compared to HFD. Investigation of the placenta showed that (i) NI reduced lipid accumulation in the labyrinth zone (LZ) but neither NI nor RUN attenuated calcification and oxidative stress. Endothelial gammaH2AX staining was decreased in the LZ by both NI and RUN. (ii) Metformin did not attenuate lipid accumulation in the LZ, placental calcification and oxidative stress, however, protein levels of the endothelial cell marker CD31 were restored in whole placenta lysates. No changes were detected for fetal vessel capillary surface or length of the LZ under any intervention group.</div></div><div><h3>Discussion</h3><div>Although all tested interventions had beneficial effects on the mother and the placental-fetal unit, NI seems to be most promising. Our findings highlight that preventive strategies for women with obesity should aim for pre-counseling advisory service. In particular, NI and RUN protected from endothelial stress response and metformin was vasculo-protective, offering strategies to preserve the physiological placental-fetal unit and materno-fetal nutrient supply.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"171 ","pages":"Pages 91-101"},"PeriodicalIF":2.5,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular health in early pregnancy and circulating placental biomarkers","authors":"Andrea C. Kozai ,&nbsp;Bethany Barone Gibbs ,&nbsp;Samuel Parry ,&nbsp;Sadiya S. Khan ,&nbsp;William Grobman ,&nbsp;Lisa D. Levine ,&nbsp;Rebecca McNeil ,&nbsp;David M. Haas ,&nbsp;Jessica L. Pippen ,&nbsp;Robert M. Silver ,&nbsp;Judith H. Chung ,&nbsp;Janet M. Catov","doi":"10.1016/j.placenta.2025.09.014","DOIUrl":"10.1016/j.placenta.2025.09.014","url":null,"abstract":"<div><h3>Background</h3><div>Maternal cardiovascular and placental health are related to pregnancy outcomes, yet how cardiovascular health (CVH) in early pregnancy affects placentation is not well characterized. Our objective was to estimate associations between CVH and concentrations of placental proteins. We hypothesized that more favorable CVH metrics would be associated with more favorable circulating concentrations of pregnancy-associated plasma protein A (PAPP-A), vascular endothelial growth factor (VEGF), placental growth factor (PlGF), soluble FMS-like tyrosine kinase 1 (sFlt-1), and soluble endoglin (sEng) in the 1st and 2nd trimesters.</div></div><div><h3>Methods</h3><div>Participants from the nuMoM2b prospective cohort with valid biomarker measures were included (n = 2188). Maternal CVH was defined using the American Heart Association's Life's Essential 8 composite score, averaging six components measured in the 1st trimester: body mass index (BMI), blood pressure, physical activity, diet, sleep duration, and smoking. Individual component scores were also evaluated. Linear regression associated scores with 1st and 2nd trimester circulating placental biomarkers.</div></div><div><h3>Results and conclusions</h3><div>Higher (more favorable) composite CVH scores were associated with higher PAPP-A (favorable) in both trimesters. In contrast, higher CVH scores were associated with lower VEGF, higher sFlt-1, and higher sEng in the 1st trimester (adverse). Healthier BMI scores demonstrated similar associations as those found with composite CVH. Greater physical activity was associated with more favorable 1st trimester profiles (higher VEGF and lower sFlt-1), but lower 2nd trimester PAPP-A. Composite CVH, potentially driven by BMI and physical activity components, may be an important factor relating to circulating concentrations of placental biomarkers in the first half of pregnancy.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"171 ","pages":"Pages 71-81"},"PeriodicalIF":2.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gestational fine particulate matter exposures and spontaneous preterm birth: Elucidating mechanisms using placental transcriptome and metabolome signatures","authors":"Jagadeesh Puvvula ,&nbsp;Aimin Chen ,&nbsp;Rebecca Simmons ,&nbsp;Rita Leite ,&nbsp;Yu-Chin Lien","doi":"10.1016/j.placenta.2025.09.012","DOIUrl":"10.1016/j.placenta.2025.09.012","url":null,"abstract":"<div><h3>Background</h3><div>This study aims to evaluate the mediating role of placental transcriptomic and metabolomic changes in the association between gestational exposure to fine particulate matter and spontaneous preterm birth (sPTB).</div></div><div><h3>Methods</h3><div>This study includes 72 participants from the CellulaR Injury and Preterm Birth Study. Daily exposure to PM_2.5 and black carbon during the first 20 weeks of pregnancy was estimated using fused 1-km resolution model outputs linked to maternal delivery addresses. High exposure was defined as days with PM_2.5 &gt;9 μg/m³ or black carbon &gt;1 μg/m³, calculated monthly across gestation. Early sPTB (&lt;32 weeks) and covariates were extracted from electronic health records. Associations between high-exposure days and expression of 432 sPTB-related genes were evaluated using gene-wise negative binomial models, and associations with 866 placental metabolites were assessed using multiple linear regression. Both analyses adjusted for covariates, using q &lt; 0.2 for statistical significance. High-dimensional mediation analysis was conducted on genes/metabolites with at least one significant hit (q &lt; 0.05).</div></div><div><h3>Results</h3><div>Black carbon exposure during gestational months 3–5 was associated with increased odds of sPTB. We identified 63 genes linked to black carbon and 50 to PM_2.5, mainly related to cellular stress, immune response, and developmental pathways. For black carbon, 23 genes showed consistent associations across multiple exposure windows (9 genes consistently negatively associated, 13 positively associated). An increase in expression of genes <em>MPO</em>, <em>ELANE</em>, and <em>GNRH2</em> mediated the association between black carbon exposure and increased sPTB.</div></div><div><h3>Conclusion</h3><div>Gestational exposure to black carbon is associated with increased odds of sPTB, and this association was mediated by altered placental gene expression.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"171 ","pages":"Pages 121-129"},"PeriodicalIF":2.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trained immunity in pregnancy: Impact on maternal-fetal outcomes and mechanistic insights.","authors":"Sirui Liu, Jia Liang, Dongyong Yang, Lingtao Yang, Songchen Cai, Linlin Wang, Tailang Yin, Lianghui Diao","doi":"10.1016/j.placenta.2025.09.015","DOIUrl":"https://doi.org/10.1016/j.placenta.2025.09.015","url":null,"abstract":"<p><p>Trained immunity, defined as the epigenetic and metabolic reprogramming of innate immune cells that shapes their subsequent responses, has emerged as a key paradigm in reproductive immunology. In pregnancy, trained immunity can act as a \"double-edged sword.\" Beneficial training of decidual NK cells and macrophages promotes vascular remodeling, tissue repair, and host defense, thereby supporting implantation and placental development. Conversely, dysregulated training triggered by hypoxia, metabolic stress, or infection may sustain chronic inflammation and contribute to preeclampsia, fetal growth restriction, and recurrent pregnancy loss. In this review, we summarize current evidence for both protective and pathogenic roles of trained immunity during pregnancy, highlight the underlying molecular mechanisms, and discuss key research gaps. Considering pregnancy complications from the perspective of trained immunity may provide new insights into pathogenesis and suggest opportunities for biomarker discovery and targeted interventions.</p>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AQP3 in amniotic epithelial cells: A key mediator of cell survival","authors":"Mauricio Di Paola ,&nbsp;Matías N. Sierra ,&nbsp;Nazarena Fernández ,&nbsp;Mariano Reynoso ,&nbsp;Mauricio Castro Parodi ,&nbsp;Alicia E. Damiano","doi":"10.1016/j.placenta.2025.09.013","DOIUrl":"10.1016/j.placenta.2025.09.013","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the regulation and functional role of aquaporin 3 (AQP3) in human amniotic epithelial cells in response to osmotic stress.</div></div><div><h3>Methods</h3><div>A human amniotic epithelial cell line (WISH) and human amnion explants were exposed to iso-, hypo-, and hyperosmotic conditions. AQP3 expression was analyzed by RT-qPCR and Western blot. The involvement of TonEBP and NF-κB was examined using specific inhibitors. Cell swelling, viability (MTT), LDH release, Bax/Bcl-2 ratio, and TUNEL staining were evaluated to determine the role of AQP3 in water transport and apoptosis.</div></div><div><h3>Results</h3><div>Hyperosmotic stress induced AQP3 expression in both models through TonEBP activation. NF-κB was also activated, but did not regulate AQP3. AQP3 blocking did not alter cell swelling, indicating a limited role in osmotic water transport. However, AQP3 inhibition or silencing reduced cell viability and increased apoptosis markers under hyperosmotic conditions. These findings suggest a cytoprotective role for AQP3.</div></div><div><h3>Conclusion</h3><div>AQP3 may act as an osmosensitive protein regulated by TonEBP, promoting survival of amniotic epithelial cells during osmotic challenge. Reduced AQP3 expression, as reported in pathological pregnancies such as oligohydramnios, might reflect a failure of this adaptive mechanism, potentially increasing the vulnerability of the amnion to stress-related damage. This may be relevant for understanding the mechanisms leading to membrane rupture in adverse pregnancies.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"171 ","pages":"Pages 82-90"},"PeriodicalIF":2.5,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the transplacental passage and breastmilk levels of broccoli sprout-derived sulforaphane","authors":"Emily F. Whalen ,&nbsp;Neville J. Fields ,&nbsp;Kirsten R. Palmer ,&nbsp;Hannah M.C. Davey ,&nbsp;Dovile Anderson ,&nbsp;Sarah A. Marshall","doi":"10.1016/j.placenta.2025.09.011","DOIUrl":"10.1016/j.placenta.2025.09.011","url":null,"abstract":"<div><h3>Introduction</h3><div>Preeclampsia is characterised by hypertension with maternal end-organ dysfunction and/or fetal growth restriction. Sulforaphane, an antioxidant found in broccoli sprouts, has potential as a future therapeutic. With its ability to attenuate the injurious impacts of endothelial dysfunction <em>in vitro</em>, sulforaphane is uniquely positioned to protect against the harmful effects of preeclampsia. However, the transferability of sulforaphane from mother to fetus/baby remains unknown in humans.</div></div><div><h3>Methods</h3><div>Uncomplicated pregnant patients (n = 8) scheduled for elective caesarean sections (&gt;37 weeks gestation) provided written and informed consent. A single oral dose of EnduraCell, a broccoli sprout extract (equivalent to 21 mg of sulforaphane), was administered prior to caesarean section. Baseline blood pressure, blood and urine were collected and again at time of operation, alongside umbilical cord blood (vein and artery) and placental samples. 2–4 days post-delivery, a second dose was administered. Two hours later, maternal bloods and breast milk were collected. Samples were processed and analysed by liquid-chromatography mass-spectrometry to measure sulforaphane.</div></div><div><h3>Results</h3><div>Besides an increase in peripheral diastolic blood pressure on the day of caesarean section (p = 0.028), there were no changes in maternal blood pressure or heart rate after ingestion of EnduraCell. Sulforaphane was found in maternal serum (70.10 ng/ml ± 11.90), umbilical cord blood (vein: 25.18 ng/mL ± 3.11, artery: 18.81 ng/mL ± 2.36), urine (5726.00 ng/mL ± 1175.00), placental tissue (10.99 ng/mg ± 2.11) and breast milk (1.33 ng/mL ± 2.29).</div></div><div><h3>Discussion</h3><div>Sulforaphane is present in the umbilical cord and breast milk, providing the world's first evidence of sulforaphane maternal-fetal transfer in humans, and opening avenues for future research into relevant fetal implications.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"171 ","pages":"Pages 62-70"},"PeriodicalIF":2.5,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: SLIMP2024.","authors":"Fernanda Giachini, Alexandre Borbely, Alicia E Damiano","doi":"10.1016/j.placenta.2025.09.010","DOIUrl":"https://doi.org/10.1016/j.placenta.2025.09.010","url":null,"abstract":"","PeriodicalId":20203,"journal":{"name":"Placenta","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SARS-CoV-2 infection disrupts syncytial and endothelial integrity and alters PlGF levels in the placenta","authors":"Brittany R. Jones ,&nbsp;Guilherme M. Nobrega ,&nbsp;Deepak Kumar ,&nbsp;Emily Diveley ,&nbsp;Arthur Antolini-Tavares ,&nbsp;Renato T. Souza ,&nbsp;José Guilherme Cecatti ,&nbsp;Jeannie C. Kelly ,&nbsp;Maria Laura Costa ,&nbsp;Indira U. Mysorekar","doi":"10.1016/j.placenta.2025.09.009","DOIUrl":"10.1016/j.placenta.2025.09.009","url":null,"abstract":"<div><h3>Introduction</h3><div>SARS-CoV-2 infection during pregnancy has been associated with an increased risk for several pregnancy-related disorders, particularly preeclampsia (PE). However, there are limited studies determining the impact of SARS-CoV-2 on placental physiology and function.</div></div><div><h3>Methods</h3><div>Placental samples were acquired from two large prospective cohorts: STOP-COVID19 and REBRACO studies. Placental villous tissues (VT) were collected from pregnant women who tested positive for SARS-CoV-2 without PE during pregnancy. Immunohistochemistry and immunofluorescence were used to assess pathological features known to be altered in PE, including 1) syncytial knot formation; 2) alterations in renin-angiotensin system components; 3) and endothelial integrity. Maternal serum was collected to examine AT₁ autoantibodies levels using an immunoassay.</div></div><div><h3>Results</h3><div>SARS-CoV-2 viral proteins spike, nucleocapsid, and ORF3a were observed in the syncytiotrophoblast layer and stroma of placental VT. SARS-CoV-2-infected placentas exhibited increased numbers of syncytial knots, which were positive for Flt-1 and SARS-CoV-2 viral proteins. In addition, the presence of placental infarctions and excessive fibrin deposits was also observed in infected placentas. Infection was associated with decreased placental expression of PlGF and an increase in the placental Flt-1/PlGF expression ratio, mostly driven by PlGF. No significant changes in maternal serum AT₁AA levels were observed. Finally, SARS-CoV-2-infected placentas exhibited a significant decrease in vimentin expression.</div></div><div><h3>Discussion</h3><div>SARS-CoV-2 infection negatively impacts placental integrity in the form of increased syncytial knots, dysregulated RAS components, and endothelial damage. Since all these features are similarly disrupted in PE, this could be a mechanism through which SARS-CoV-2 infection during pregnancy increases the risk of a PE-like syndrome.</div></div>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":"171 ","pages":"Pages 34-44"},"PeriodicalIF":2.5,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Participation of kynurenine pathway metabolites in Trypanosoma cruzi infection of human placenta.","authors":"María José Moreira-Espinoza, Luciana Mezzano, Martin G Theumer, Graciela María Panzetta-Dutari, María Fernanda Triquell, Cintia María Díaz-Luján, Ricardo E Fretes","doi":"10.1016/j.placenta.2025.09.008","DOIUrl":"https://doi.org/10.1016/j.placenta.2025.09.008","url":null,"abstract":"<p><strong>Introduction: </strong>The kynurenine pathway is a major route of tryptophan (Trp) metabolism, an essential amino acid. This pathway, mediated by Indoleamine 2,3-dioxygenase (IDO), contributes to maternal-fetal tolerance by depletion Trp and generating kynurenines (Kyn). Among the Kyns produced in the placenta, 3-hydroxykynurenine (3-HK) and 3-hydroxy-anthranilic acid (3-HAA) have been shown to affect T. cruzi replication. This study aimed to evaluate the role of kynurenine pathway metabolites in Trypanosoma cruzi (T. cruzi) infection of the human placenta.</p><p><strong>Methods: </strong>Term human placental explants (n = 8) were infected with 10⁵ T. cruzi trypomastigotes/mL for 24 h. The explants were treated with L-Trp, L-1-methyl-tryptophan (L-1MT), IFN-γ, 3-HK and 3-HAA for 72 or 96 hpi. IDO expression was assessed by immunohistochemistry, and IDO activity was measured in homogenates. L-Kyn concentration was quantified in culture supernatants, while infection levels were determined by qPCR. Statistical analysis included ANOVA with Tukey's post hoc test and Student's t-test (p < 0.05).</p><p><strong>Results: </strong>L-Trp increased IDO expression and activity, elevating L-Kyn production in both infected and non-infected explants. L-1MT reduced L-Kyn production, whereas IFN-γ stimulated it. Additionally, 3-HK significantly impaired trypomastigotes motility. Both 3-HK and 3-HAA decreased placenta explant infection by T. cruzi.</p><p><strong>Conclusion: </strong>Metabolites of the kynurenine pathways reduced T. cruzi infection in placental explants, suggesting a potential role in limiting congenital transmission of Chagas disease by modulating parasitic load in human placenta.</p>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decoding the multifactorial etiology of chronic endometritis.","authors":"Guanying You, Shuyi Yu, Meng Liu, Lianghui Diao, Ruochun Lian, Yuye Li","doi":"10.1016/j.placenta.2025.09.007","DOIUrl":"https://doi.org/10.1016/j.placenta.2025.09.007","url":null,"abstract":"<p><p>Chronic endometritis (CE) is a persistent inflammatory disorder of the endometrium, typically marked by abnormal plasma cell infiltration. It is closely associated with adverse pregnancy outcomes. The pathogenesis of CE involves a complex interplay of both infectious and non-infectious factors. Infectious etiologies include ascending infection pathways, pelvic infection pathways, sexually transmission, hematogenous infection pathways and special infections, while non-infectious factors encompass uterine structural pathology, autoimmune disorders and iatrogenic factors. Considering the multifactorial etiology of CE, adopting a personalized management approach that integrates both microbial and immune factors may enhance pregnancy outcomes for CE women.</p>","PeriodicalId":20203,"journal":{"name":"Placenta","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}