Pregnancy complications recur independently of maternal vascular malperfusion lesions
| Autor: | Julian K. Christians, Maria F. Huicochea Munoz |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Embryology viruses Placenta Maternal Health Intrauterine growth restriction Miscarriage Biochemistry Pediatrics 0302 clinical medicine Child Development Pregnancy Recurrence Medicine and Health Sciences 030219 obstetrics & reproductive medicine Multidisciplinary Obstetrics Pregnancy Outcome Gestational age Obstetrics and Gynecology Medicine Female medicine.symptom Anatomy Research Article Adult medicine.medical_specialty Child Growth Science Early Pregnancy Loss Preeclampsia Lesion 03 medical and health sciences medicine Humans Placental Circulation Fetal Death Retrospective Studies Fibrin Growth Restriction business.industry Reproductive System Biology and Life Sciences Proteins Retrospective cohort study biochemical phenomena metabolism and nutrition medicine.disease Placentation Pregnancy Complications 030104 developmental biology Women's Health business Developmental Biology |
| Zdroj: | PLoS ONE PLoS ONE, Vol 15, Iss 2, p e0228664 (2020) |
| ISSN: | 1932-6203 |
| Popis: | Background Spontaneous abortions, intrauterine growth restriction, and preeclampsia are thought to be caused by defective placentation and are associated with increased risk of adverse outcomes in subsequent pregnancies. However, it is not known whether the recurrence of adverse outcomes is associated with the recurrence of placental pathology. We hypothesized that recurrent maternal vascular malperfusion (MVM) underlies the recurrence of adverse outcomes. Methods Using data from the National Collaborative Perinatal Project, we assessed the recurrence of pregnancy complications and MVM lesions (N = 3865), associations between a history of spontaneous abortions and MVM lesions or adverse outcomes in subsequent pregnancies (N = 8312), and whether the recurrence of pregnancy complications occurred independently of the presence of MVM lesions. Results The odds of an MVM lesion were higher for a woman who had had an MVM lesion in a previous pregnancy (aOR = 1.6; 95% CI 1.3–1.9), although this was marginally non-significant after adjusting for covariates such as gestational age, race and BMI. The odds of preeclampsia, a small-for-gestational-age infant, premature delivery and early pregnancy loss were 2.7–5.0 times higher if there had been that same adverse outcome in a previous pregnancy. A history of spontaneous abortions was associated with higher risk of a small-for-gestational-age baby (aOR = 2.4; 95% CI 1.7–3.4) and prematurity (aOR = 5.1; 95% CI 2.3–11.5 for extremely preterm), but not preeclampsia. The recurrence of adverse outcomes was significant when restricting analyses to women without MVM lesions. Similarly, associations between adverse outcomes and previous spontaneous abortions were significant when statistically controlling for the presence of MVM lesions, or excluding pregnancies with MVM lesions. Conclusions Women with adverse outcomes in one pregnancy are at higher risk of complications in subsequent pregnancies. However, there is significant recurrence of adverse outcomes even in the absence of MVM. |
| Databáze: | OpenAIRE |
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