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.
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。