| Titre : | Placental Vascular Pathology Findings and Pathways to Preterm Delivery. (2009) |
| Auteurs : | R. KELLY ; H. CHUNG ; C. HOLZMAN ; RAHBAR (M.H.) : USA. Divisions of Epidemiology and Biostatistics. The University of Texas School of Public Health at Houston. Houston. TX. ; SENAGORE (P.) : USA. Division of Human Pathology. College of Human Medicine. Michigan State University. East Lansing. MI. ; Y. TIAN ; J. WANG |
| Type de document : | Article |
| Dans : | American journal of epidemiology (vol. 170, n° 2, 2009) |
| Pagination : | 148-158 |
| Langues: | Anglais |
| Mots-clés : | Prématurité ; Vaisseau ; Grossesse ; Placenta ; Naissance ; Epidémiologie ; Homme ; Appareil cardiovasculaire |
| Résumé : | [BDSP. Notice produite par INIST-CNRS r8q9R0xH. Diffusion soumise à autorisation]. The authors examined the associations between placental vascular findings and preterm delivery in 1,053 subcohort women (239 preterm, 814 term) from a Michigan pregnancy cohort study (1998-2004). Twenty-nine placental vascular variables from microscopic examinations were grouped into 5 constructs : 3 maternal constructs-obstructive lesions (MV-O), bleeding/vessel integrity (MV-I), and lack of physiologic conversion of maternal spiral arteries (MV-D) - and 2 fetal constructs-obstructive lesions (FV-O) and bleeding/vessel integrity (FV-I). Construct-specific scores were created by adding the number of positive findings and deriving a dichotomous variable to approximate the top quintile ("high") and bottom 4 quintiles ("not high") within each construct. In multivariate polytomous logistic regression models, medically indicated preterm delivery at<35 weeks was significantly associated with high scores for each of the vascular constructs ; adjusted odds ratios ranged from 2.4 to 5.4. Spontaneous preterm delivery at 35-36 weeks was significantly associated with a high score on any 1 of 3 constructs : MV-I, MV-D, and FV-I. Spontaneous preterm delivery at<35 weeks was significantly associated with a high score on 2 or more of 3 constructs : MV-I, MV-D, and FV-I ; adjusted odds ratios ranged from 4.1 to 7.4. These results support a role for various placental vascular lesions in medically indicated and spontaneous preterm delivery. |
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