J Pathol Transl Med.  2018 Sep;52(5):290-297. 10.4132/jptm.2018.07.09.

Chronic Placental Inflammation as a Risk Factor of Severe Retinopathy of Prematurity

Affiliations
  • 1Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. euisjung@amc.seoul.kr
  • 2Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 3Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

BACKGROUND
Chronic placental inflammation (CPI) has been implicated in the pathogenesis of diseases in premature infants, whereas retinopathy of prematurity (ROP) is a major complication primarily affecting preterm and very low-birth-weight (VLBW) infants. This study aims to investigate the association between CPI and ROP in VLBW infants.
METHODS
We performed a retrospective review of clinical records of VLBW infants born between 2013 and 2016. Placental pathology findings including CPI cases were analyzed using logistic regression to study infants' morbidities and other clinical characteristics.
RESULTS
A total of 402 infants with a mean (standard deviation) gestational age of 28.5 (2.8) weeks and birth weight of 1,027.2 (304.4) g were included. The incidence of ROP was 24.1%. CPI was found in 90 infants (22.4%), among which 28.9% (26 of 90) developed ROP, and 21.1% (19 of 90) underwent laser photocoagulation. Lower gestational age, lower birth weight, longer duration of oxygen supply, and presence of CPI were associated with the development of ROP. After adjustment for gestational age, birth weight, sex, duration of oxygen supply, and other overlapping placental pathology, CPI was associated with the odds for type 1 ROP that required laser photocoagulation (adjusted odds ratio, 2.739; 95% confidence interval, 1.112 to 6.749; p = .029).
CONCLUSIONS
CPI was associated with severe ROP requiring treatment with laser photocoagulation in VLBW infants.

Keyword

Chronic chorioamnionitis; Villitis; Deciduitis; Retinopathy of prematurity; Infant, very low birth weight

MeSH Terms

Birth Weight
Gestational Age
Humans
Incidence
Infant
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight
Inflammation*
Light Coagulation
Logistic Models
Odds Ratio
Oxygen
Pathology
Retinopathy of Prematurity*
Retrospective Studies
Risk Factors*
Oxygen

Figure

  • Fig. 1. Study population. VLBW, very low-birth-weight.

  • Fig. 2. Microscopic features of chronic chorioamnionitis and acute funisitis (representative case). (A) Lymphocytes (arrow) infiltrate into the chorionic trophoblast layer of the chorioamniotic membrane. (B) Neutrophils (arrow) infiltrate into the smooth muscle layer of the umbilical artery.


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