Lerluck Sakdapreecha1 M.D., Pilaiwan Kleebkaow2 M.D., Supinda Koonmee1 M.D., Chumnan Kietpeerakool2 M.D., Thippawan Triamwittayanon1
1Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand,
2Department of Obstetrics & Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Objective: To determine the association between preterm births (PTBs) and placental villous hypermaturation (PVH), a pathological ﬁ nding which suggests placental insufﬁ ciency.
Methods: This retrospective study was conducted at Srinagarind Hospital, Khon Kaen University, Thailand during 2011 and 2015. Medical records of women with PTBs were reviewed for demographic data and causes of PTBs. All placental specimens were re-examined to ensure diagnoses of PVH. It is our routine practice to evaluate placental pathology in all cases with PTBs.
Results: Of 97 women with PTBs, 34 (35.1%) were found to have identiﬁ able causes of PTBs including chorioamnionitis, intrauterine growth restriction, preeclampsia, maternal heart disease, and maternal systemic lupus erythematosus. Of 97 placental specimen examined, PVH was noted in 70 specimens (72.16%; 95% conﬁ dence interval, 62.1%-80.8%). Prevalence of PVH among idiopathic spontaneous PTBs was slightly higher than that in PTBs with known causes (74.6% versus 67.6%, respectively). This difference however did not reach statistical signiﬁ cant level (P=0.47). The prevalence of PVH was increased in pregnant women aged younger than 35 years compared to older pregnant women (86.1% versus 32.0%, P<0.001). The prevalence of PVH was positively associated with gestational age (GA) (92.3% in GA less than 28 weeks, 85.1% in GA between 28-33 weeks, and 48.7% in GA 34 weeks or more, P<0.001).
Conclusion: Prevalence of PVH is considerably high among PTBs, particularly in those with idiopathic spontaneous PTBs. Factors associated with PVH among women with PTBs included maternal age and gestation age.