Patterns of Gene Expression in Chorionic Villous Tissue Based on Patterns of Placental Pathology

We sought to investigate gene expression in placentas impacted by major patterns of injury: acute inflammation (AI), chronic inflammation (CI), and maternal vascular malperfusion (MVM).

We utilized placental tissue prospectively collected between 2017 and 2020. Chorionic villous biopsies were collected following delivery and samples were also submitted for histologic examination. Placentas with ≥2 types of placental injury after histology examination were excluded. Linear models, adjusted for covariates, were used to compare each pathology group to histologically normal control placentas. Transcripts with fold-change of >2 or <0.5 served as input for higher-order bioinformatic analyses, focused on identifying transcription control pathways and the cellular populations involved.

One hundred and sixty-four placentas were included: 60 AI, 25 CI, 39 MVM, and 40 controls. In bioinformatic analyses each pathology group displayed a unique signature, with distinct transcription binding factor activity involved including pathways involved in cell signaling, cell proliferation, and cell differentiation.

We show unique patterns of transcriptional control for each pathology-defined type of placental injury. MVM, CI, and AI represent not only unique histologic patterns, but also express unique molecular signatures.