Creating a placental inflammatory composite index that has a high prognostic relevance to child morbidity. Issue 7 (31st May 2017)

• Record Type: Journal Article
• Authors: Chen, Yan; Zou, Lile; Zhao, Yanjun; Wu, Ting; Ye, Jiangfeng; Zhang, Huijuan; Zhang, Jun
• Is Part Of: Journal of obstetrics and gynaecology research. Volume 43:Issue 7(2017)
• Page Start: 1169
• Page End: 1179
• Publication Date: 2017-05-31
• Subjects: child morbidity -- composite index -- placental inflammation‐related measure -- prognostic relevance; Gynecology -- Periodicals; Obstetrics -- Periodicals; 618.1005
• DOI: 10.1111/jog.13328
• Languages: English
• ISSNs: 1341-8076

Abstract

Abstract: Aim: Selecting pathologic measures of placental inflammation that affect pregnancy and childhood health is largely empirical. We aimed to systematically select several core inflammation‐related placental measures to construct a novel placental inflammatory evaluation criterion with a high prognostic relevance to child morbidity. Methods: We used data from the US Collaborative Perinatal Project (1959–1976), a longitudinal birth cohort study that recruited women during pregnancy and followed the children until 7 years of age. Bootstrap resampling, least absolute shrinkage and selection operator, and receiver–operator curve were used to select placental pathologic measures that were closely related to child morbidity to form a placental inflammatory composite index. Results: Twenty‐six candidate placental inflammation‐related measures were ranked based on their close association with adverse neonatal outcomes. The top five placental measures were: (i) neutrophilic infiltration in umbilical artery; (ii) placental weight–birthweight ratio; (iii) necrosis in decidua capsularis ; (iv) bacterial colony in epithelium of amnion; and (v) opacity of membranes and fetal surface. Several composite indexes were constructed. A five‐measure composite index that had the highest prognostic relevance was chosen. Compared with subjects without any of the five abnormal measures, those with any lesion ranging from 1 to 5 had a 1.2‐ to 4.6‐fold risk of adverse child outcomes, respectively. Conclusion: Our composite index is simple, evidence‐based, and has predictive value for child morbidity. It may be used as a novel placental inflammatory evaluation criterion.