Abstract：
BACKGROUND: We aimed to investigate the association between perinatal outcomes and placental pathological features in pregnant women with ACTD, including systemic lupus erythematosus (SLE), antiphospholipid antibody syndrome (APS), and undifferentiated connective tissue disease (UCTD).
METHODS: Placental tissue from SLE (n = 44), APS (n = 45), and UCTD (n = 45) were included, and contemporaneous deliveries of placenta were served as a control group (n = 46) between September 2015 and March 2021. The placental histopathology was evaluated using the Manual of Human Placental Pathology and classified according to the Amsterdam consensus framework.
RESULTS: SLE pregnant women have a higher rate of cesarean section (61.40%), premature birth (24.56%), and SGA (26.32%) when compared to control group (p = 0.008, p = 0.005, and p = 0.000, respectively). The rate of vascular malperfusion, inflammatory-immune lesions, and other placental lesions in the SLE group was 47.73%, 56.82%, and 63.64%, which were higher than the control group (p = 0.000, p = 0.000, and p = 0.006, respectively). In the meantime, the incidence of inflammatory-immune lesions in the APS group (42.22%, p = 0.004) and vascular malperfusion in the UCTD group (37.78%, p = 0.007) were increased when compared to the control group.
CONCLUSIONS: SLE appeared to confer increased risk for a wide range of adverse perinatal outcomes. We determined elevated placental histopathology risk for most women with ACTD, including vascular maldevelopment, vascular malperfusion, and inflammatory-immune lesions.
METHODS: Placental tissue from SLE (n = 44), APS (n = 45), and UCTD (n = 45) were included, and contemporaneous deliveries of placenta were served as a control group (n = 46) between September 2015 and March 2021. The placental histopathology was evaluated using the Manual of Human Placental Pathology and classified according to the Amsterdam consensus framework.
RESULTS: SLE pregnant women have a higher rate of cesarean section (61.40%), premature birth (24.56%), and SGA (26.32%) when compared to control group (p = 0.008, p = 0.005, and p = 0.000, respectively). The rate of vascular malperfusion, inflammatory-immune lesions, and other placental lesions in the SLE group was 47.73%, 56.82%, and 63.64%, which were higher than the control group (p = 0.000, p = 0.000, and p = 0.006, respectively). In the meantime, the incidence of inflammatory-immune lesions in the APS group (42.22%, p = 0.004) and vascular malperfusion in the UCTD group (37.78%, p = 0.007) were increased when compared to the control group.
CONCLUSIONS: SLE appeared to confer increased risk for a wide range of adverse perinatal outcomes. We determined elevated placental histopathology risk for most women with ACTD, including vascular maldevelopment, vascular malperfusion, and inflammatory-immune lesions.
摘要：
背景：我们旨在调查ACTD孕妇的围产期结局与胎盘病理特征之间的关系，包括系统性红斑狼疮（SLE），抗磷脂抗体综合征（APS），和未分化结缔组织病（UCTD）。
方法：SLE胎盘组织（n=44），APS（n=45），和UCTD（n=45）包括在内，在2015年9月至2021年3月期间,将同期分娩胎盘作为对照组(n=46).使用人类胎盘病理学手册评估胎盘组织病理学，并根据阿姆斯特丹共识框架进行分类。
结果:SLE孕妇剖宫产率较高(61.40%),早产（24.56%），与对照组相比，SGA（26.32％）（分别为p=0.008，p=0.005和p=0.000）。血管灌注不良的发生率,炎症-免疫损伤，SLE组其他胎盘病变占47.73%,56.82%，和63.64%，均高于对照组(分别为p=0.000、p=0.000和p=0.006)。同时,APS组炎症-免疫病变的发生率(42.22%,p=0.004）和UCTD组的血管灌注不良（37.78％，与对照组相比，p=0.007）增加。
结论：SLE似乎增加了围产期各种不良结局的风险。我们确定了大多数ACTD女性胎盘组织病理学风险升高，包括血管发育不良,血管灌注不良,和炎症免疫损伤。
方法：SLE胎盘组织（n=44），APS（n=45），和UCTD（n=45）包括在内，在2015年9月至2021年3月期间,将同期分娩胎盘作为对照组(n=46).使用人类胎盘病理学手册评估胎盘组织病理学，并根据阿姆斯特丹共识框架进行分类。
结果:SLE孕妇剖宫产率较高(61.40%),早产（24.56%），与对照组相比，SGA（26.32％）（分别为p=0.008，p=0.005和p=0.000）。血管灌注不良的发生率,炎症-免疫损伤，SLE组其他胎盘病变占47.73%,56.82%，和63.64%，均高于对照组(分别为p=0.000、p=0.000和p=0.006)。同时,APS组炎症-免疫病变的发生率(42.22%,p=0.004）和UCTD组的血管灌注不良（37.78％，与对照组相比，p=0.007）增加。
结论：SLE似乎增加了围产期各种不良结局的风险。我们确定了大多数ACTD女性胎盘组织病理学风险升高，包括血管发育不良,血管灌注不良,和炎症免疫损伤。
