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Placental histopathology in preterm birth with confirmed maternal infection: A systematic literature review

Abstract:
Four in five neonatal deaths of preterm births occur in low and middle income countries and placental histopathology examination can help clarify the pathogenesis. Infection is known to play a significant role in preterm birth. The aim of this systematic review is to explore the association between placental histopathological abnormality and preterm birth in the presence of confirmed infection. PubMed/Medline, Scopus, Web of Science and Embase were searched using the keywords related to preterm birth, placental histopathology and infection. Titles and abstracts were screened and the full texts of eligible articles were reviewed to extract and summarise data. Of 1529 articles, only 23 studies (13 bacterial, 6 viral and 4 parasitic) were included, and they used 7 different gestational age windows, and 20 different histopathological classification systems, precluding data pooling. Despite this, histopathological chorioamnionitis, and funisitis (when examined) were commonly observed in preterm birth complicated by confirmed bacterial or viral, but not parasitic, infection. The presence of malaria parasites but not pigment in placenta was reported to increase the risk of PTB, but this finding was inconclusive. One in three studies were conducted in low and middle income countries. An array of: definitions of preterm birth subgroups, histological classification systems, histopathologic abnormalities and diagnostic methods to identify infections were reported in this systematic review. Commitment to using standardised terminology and classification of histopathological abnormalities associated with infections is needed to identify causality and potential treatment of preterm birth. Studies on preterm birth needs to occur in high burden countries and control for clinical characteristics (maternal, fetal, labor, and placental) that may have an impact on placental histopathological abnormalities.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1371/journal.pone.0255902

Authors


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Role:
Author
ORCID:
0000-0003-4438-0888
More by this author
Role:
Author
ORCID:
0000-0002-1667-9287
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Role:
Author
ORCID:
0000-0003-0135-9317
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Institution:
University of Oxford
Division:
MSD
Department:
NDM
Sub department:
Tropical Medicine
Role:
Author
ORCID:
0000-0002-7951-0745


Publisher:
Public Library of Science
Journal:
PLOS ONE More from this journal
Volume:
16
Issue:
8
Article number:
e0255902
Place of publication:
United States
Publication date:
2021-08-12
Acceptance date:
2021-07-26
DOI:
EISSN:
1932-6203
Pmid:
34383833


Language:
English
Keywords:
Pubs id:
1190741
Local pid:
pubs:1190741
Deposit date:
2021-12-22

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