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Updated: Feb 10, 2026
14:43
A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
13.5K
Classification of Preterm Birth With Placental Correlates
Karen M Chisholm1, Mary E Norton2, Anna A Penn3
11 Department of Pathology, Stanford University School of Medicine, Stanford, California.
Summary
Maternal vascular malperfusion is common in preterm birth placentas across various clinical categories. These placental findings may link different preterm birth causes, suggesting early pregnancy origins for these conditions.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Pathology
- Neonatology
Background:
- A unified classification for premature birth integrating clinical and placental factors is lacking.
- Understanding placental pathology is crucial for classifying and managing preterm birth.
Purpose of the Study:
- To investigate associations between clinical preterm birth categories and placental histology.
- To explore potential unifying mechanisms underlying diverse preterm birth presentations.
Main Methods:
- Analysis of placental histology in 109 preterm infants (<34 weeks gestation, <2000g).
- Classification of placentas based on amniotic fluid infection, inflammation, and vascular malperfusion.
- Correlation of placental findings with clinical preterm birth categories.
Main Results:
- Maternal vascular malperfusion was prevalent in all preterm birth categories.
- Maternal vascular malperfusion associated with preeclampsia; amniotic fluid infection with preterm rupture of membranes.
- Lymphocytic inflammation and decidual necrosis linked to abruption; multiple gestations showed fewer findings.
Conclusions:
- Placental maternal vascular malperfusion is a common feature across diverse preterm birth types.
- Ascending infections and inflammation may be mechanistically related to maternal vascular malperfusion.
- The concept of 'uterine ischemia' may be insufficient to explain all preterm placental changes.
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