Trophoblast inclusions and adverse birth outcomes

Area of Science:

• Perinatal pathology
• Reproductive medicine
• Obstetrics

Background:

• Trophoblast inclusions, identified as abnormal trophoblast bilayer infoldings, have been previously linked to aneuploidy, placenta accreta, and preterm birth.
• Understanding the full spectrum of outcomes associated with trophoblast inclusions is crucial, especially in populations with high environmental exposures.

Purpose of the Study:

• To investigate the relationship between trophoblast inclusions and various placental, pregnancy, and birth outcomes.
• To evaluate the association of trophoblast inclusions with full-term birth, preterm birth, stillbirth, gestational age, and specific placental pathologies.

Main Methods:

• Evaluation of chorionic villi slides from 589 placentas collected in the Safe Passage Study cohort.
• The study included subsamples from full-term live births, preterm live births, and stillbirths.

Main Results:

• Trophoblast inclusions were significantly more frequent in placentas from preterm (OR = 1.74) and stillborn (OR = 4.95) deliveries compared to term liveborn deliveries.
• Inclusion frequency correlated inversely with gestational age at delivery.
• Associations were found with small for gestational age birthweight, labor induction, villous edema, placental infarction, and chorionic plate inflammation.

Conclusions:

• Novel associations between trophoblast inclusions and adverse pregnancy outcomes are reported.
• Further research is needed to elucidate the biological mechanisms underlying these associations.
• Findings may inform clinical and research applications for pregnancy health.