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Cited by 153Preterm Birth and ChorioamnionitisReproductive System and PregnancyCOVID-19 Impact on Reproduction

Placental inflammation and viral infection are implicated in second trimester pregnancy loss

Srinivas, Sindhu K., Ma, Yujie, Sammel, Mary D., Chou, Doris, McGrath, Cindy, Parry, Samuel, Elovitz, Michal A.·2006·American Journal of Obstetrics and Gynecology
DOI 10.1016/j.ajog.2006.05.049
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Abstract

Objective Second trimester pregnancy loss continues to be a poorly understood adverse obstetric outcome. A case control study was performed to determine if: (1) similar to early spontaneous preterm birth, second trimester loss is associated with histologic chorioamnionitis (HCA); and (2) if HCA is present, which organisms may mediate this placental inflammation.Study design Cases were patients with a spontaneous second trimester loss. Controls were patients who presented for induction of labor for fetal or maternal indications. Nested polymerase chain reaction (PCR) was performed on placental tissues to detect the presence of viruses and pathogenic and atypical bacteria. Chi-square and Fisher exact test were used to determine if HCA and/or the presence of virus or bacteria were significantly associated with second trimester loss. The associations of interest were adjusted for possible confounders using multivariable logistic regression.Results HCA was more prevalent in cases (67%) than controls (16%) (P < .001). Seventy-nine percent (66/84) of cases and 44% (7/16) of controls were positive for any virus (P = .01). The rate of bacterial infection was similar in both cases and controls (P = .35). In multivariable logistic regression models, HCA (odds ratio [OR] 14.58, 2.62-81.15) and the presence of any virus (OR 6.62, 1.56-28.07) were independently associated with second trimester loss.Conclusion These studies demonstrate that spontaneous second trimester loss is strongly associated with HCA and viral infections.

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  • Viral DNAs in the amniotic fluid of asymptomatic women undergoing genetic amniocentesis were generally unrelated to subsequent preterm births, so it seems unlikely that maternal viral infection plays an important part in preterm birth.

    “In several studies, the viral DNAs—identified by PCR techniques—in the amniotic fluid of asymptomatic women undergoing genetic amniocentesis were generally unrelated to subsequent preterm births;115 therefore, it seems unlikely that maternal viral infection plays an important part in preterm birth, but controversy persists, and with little information, further study is needed.116”

    From Epidemiology and causes of preterm birth (2008) · cites this paper as [116]

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Authors
Srinivas, S. K., Ma, Y., Sammel, M. D., Chou, D., McGrath, C., Parry, S., & Elovitz, M. A.
Affiliations
University of Pennsylvania Health System (US)
Corresponding author
Srinivas, Sindhu K.
ORCID
Venue
American Journal of Obstetrics and Gynecology
Publisher
Elsevier BV
Published
2006-09
Volume
195
Issue
3
Pages
797-802
ISSN
0002-9378 (ISSN-L)
DOI
10.1016/j.ajog.2006.05.049
OpenAlex
W2033358592
Cited by
153
References
24
Citations by year
2026: 7 · 2025: 3 · 2024: 6 · 2023: 11 · 2022: 15 · 2021: 13 · 2020: 8 · 2019: 8 · 2018: 10 · 2017: 10 · 2016: 8 · 2015: 8 · 2014: 9 · 2013: 5 · 2012: 3
FWCI
3.43
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • American Journal of Obstetrics and Gynecology (publishedVersion)
  • PubMed (publishedVersion)
Funders
Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD42100, R01HD042100)
Topics
  • Health Sciences › Medicine › Epidemiology › Preterm Birth and Chorioamnionitis
  • Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
  • Health Sciences › Medicine › Obstetrics and Gynecology › COVID-19 Impact on Reproduction
Keywords
second-trimester pregnancy loss, miscarriage, histological chorioamnionitis, placental inflammation, viral infection, placental infection, bacterial infection, atypical bacteria, placental histology
MeSH terms
Abortion, Spontaneous, Adult, Chorioamnionitis, Female, Gestational Age, Humans, Placenta, Pregnancy, Pregnancy Complications, Infectious, Pregnancy Trimester, Second, Prospective Studies, Logistic Models, Case-Control Studies

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