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Teratogenicity

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The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...

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Mouse In Vivo Placental Targeted CRISPR Manipulation

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Formulating a Meaningful and Comprehensive Placental Phenotypic Classification.

Alexa A Freedman^1,2, Lauren S Keenan-Devlin³, Ann Borders^3,4,5

¹Institute for Policy Research, Northwestern University, Evanston, Illinois.

Pediatric and Developmental Pathology : the Official Journal of the Society for Pediatric Pathology and the Paediatric Pathology Society

|April 19, 2021

Summary

Overlapping placental lesions, particularly maternal vascular malperfusion (MVM) combined with inflammation or fetal malperfusion, significantly increase risks for small for gestational age (SGA) infants and preterm birth (PTB). This study defines new placental phenotypes to predict adverse birth outcomes.

Keywords:

birth weight infant inflammation pathologist placenta premature birth small for gestational age birth

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Area of Science:

Obstetrics and Gynecology
Perinatal Medicine
Pathology

Background:

Placental lesions are known indicators of adverse pregnancy outcomes.
The impact of multiple, overlapping placental pathologies on birth outcomes remains underexplored.

Purpose of the Study:

To investigate patterns of overlapping placental lesions.
To define meaningful placental phenotypes associated with adverse birth outcomes.
To evaluate the association of these phenotypes with preterm birth (PTB) and small for gestational age (SGA) infants.

Main Methods:

Analysis of 19,027 placental pathology reports (2009-2018).
Classification of lesions into acute inflammation (AI), chronic inflammation (CI), maternal vascular malperfusion (MVM), and fetal vascular malperfusion (FVM) categories, with grading (low/high).
Evaluation of lesion combinations and their correlation with PTB and SGA.

Main Results:

Maternal vascular malperfusion (MVM), especially combined with CI and/or FVM, showed the highest association with SGA infants and PTB.
Twenty-one distinct placental phenotype groups were identified, each linked to specific patterns of SGA and PTB.
The severity and multiplicity of lesions were critical factors in determining associations.

Conclusions:

A comprehensive placental phenotype incorporating lesion severity and multiplicity has been developed.
This new classification system aids in understanding and predicting adverse birth outcomes.
A web application is available to assist in determining placental phenotypes.