The prevalence of histologic acute chorioamnionitis among HIV infected pregnant women in Uganda and its association with adverse birth outcomes
Preterm birth (PTB) is a leading cause of neonatal mortality and longer-term morbidity. Acute chorioamnionitis (ACA) is a common cause of PTB, however, there are limited data on the prevalence of ACA and its association with PTB in resource limited settings. Data and samples came from a clinical tri...
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| Veröffentlicht in: | PloS one 2019-04, Vol.14 (4), p.e0215058-e0215058 |
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| creator | Ategeka, John Wasswa, Razack Olwoch, Peter Kakuru, Abel Natureeba, Paul Muehlenbachs, Atis Kamya, Moses R Dorsey, Grant Rizzuto, Gabrielle |
| description | Preterm birth (PTB) is a leading cause of neonatal mortality and longer-term morbidity. Acute chorioamnionitis (ACA) is a common cause of PTB, however, there are limited data on the prevalence of ACA and its association with PTB in resource limited settings.
Data and samples came from a clinical trial evaluating novel strategies for the prevention of malaria in HIV infected pregnant women in Uganda. Women were enrolled between 12-28 weeks of gestation and followed through delivery. For each placenta delivered, three placental tissue types (membrane roll, umbilical cord and chorionic plate/villous parenchyma) were collected. Slides were assessed for diagnosis of maternal and fetal ACA by microscopic evaluation of neutrophilic infiltration using a standardized grading scale. The primary outcomes were PTB ( |
| doi_str_mv | 10.1371/journal.pone.0215058 |
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Data and samples came from a clinical trial evaluating novel strategies for the prevention of malaria in HIV infected pregnant women in Uganda. Women were enrolled between 12-28 weeks of gestation and followed through delivery. For each placenta delivered, three placental tissue types (membrane roll, umbilical cord and chorionic plate/villous parenchyma) were collected. Slides were assessed for diagnosis of maternal and fetal ACA by microscopic evaluation of neutrophilic infiltration using a standardized grading scale. The primary outcomes were PTB (<37 weeks), low birth weight (LBW, <2500 grams), and small-for-gestational age (SGA, birth weight <10th percentile for age). Univariate and multivariate logistic regression were used to estimate associations between 1) maternal characteristics (age, education, wealth, gravidity, gestational age at enrollment, placental malaria, anti-malarial prophylaxis treatment regimen, HIV disease parameters) and ACA, and 2) associations between ACA and adverse birth outcomes.
A total of 193 placentas were included in the analysis. The prevalence of maternal and fetal ACA was 44.5% and 28.0%, respectively. HIV infected women between 28-43 years of age had a higher risk of maternal ACA compared to those between 17-21 years of age (50.9% vs. 19.1%; aOR = 4.00 (1.10-14.5), p = 0.04) and the diagnosis of severe maternal ACA was associated with a significantly higher risk of PTB (28.6% vs. 6.0%; aOR = 6.04 (1.87-19.5), p = 0.003), LBW (33.3% vs. 9.4%; aOR = 4.86 (1.65-14.3); p = 0.004), and SGA (28.6% vs. 10.1%; aOR = 3.70 (1.20-11.4), p = 0.02). No maternal characteristics were significantly associated with fetal ACA and the diagnosis of fetal ACA was not associated with adverse birth outcomes.
Histological evidence of severe maternal ACA was associated with an increased risk of PTB, LBW, and SGA in HIV infected, pregnant Ugandan women.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0215058</identifier><identifier>PMID: 30973949</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acquired immune deficiency syndrome ; Acute Disease ; Adolescent ; Adult ; Age ; AIDS ; Analysis ; Archives & records ; Babies ; Biology and Life Sciences ; Birth Weight ; Cerebral palsy ; Childbirth & labor ; Chorioamnionitis ; Chorioamnionitis - physiopathology ; Clinical trials ; Collaboration ; Diagnosis ; Disease prevention ; Disease transmission ; Double-Blind Method ; Efavirenz ; Evaluation ; Female ; Fetal Growth Retardation - etiology ; Fetal Growth Retardation - pathology ; Fetuses ; Gestation ; Gestational age ; Health aspects ; Health risks ; HIV ; HIV - isolation & purification ; HIV Infections - complications ; HIV Infections - epidemiology ; Human immunodeficiency virus ; Humans ; Infant mortality ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Small for Gestational Age ; Infections ; Infectious diseases ; Infiltration ; Inflammation ; Laboratories ; Leukocytes (neutrophilic) ; Low birth weight ; Malaria ; Medical diagnosis ; Medical treatment ; Medicine ; Medicine and Health Sciences ; Membranes ; Morbidity ; Mortality ; Neonates ; Neutrophils ; Newborn infants ; Parenchyma ; Pathology ; Placenta ; Pregnancy ; Pregnancy Complications, Infectious - etiology ; Pregnant women ; Premature birth ; Prevalence studies (Epidemiology) ; Prophylaxis ; Regression analysis ; Risk ; Small for gestational age ; Tropical diseases ; Uganda - epidemiology ; Umbilical cord ; Vector-borne diseases ; Weight ; Womens health ; Young Adult</subject><ispartof>PloS one, 2019-04, Vol.14 (4), p.e0215058-e0215058</ispartof><rights>COPYRIGHT 2019 Public Library of Science</rights><rights>This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication: https://creativecommons.org/publicdomain/zero/1.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-f28ba50915d31a478bff5996b05394f5456c301e5d3a5eec18139940f114775c3</citedby><cites>FETCH-LOGICAL-c692t-f28ba50915d31a478bff5996b05394f5456c301e5d3a5eec18139940f114775c3</cites><orcidid>0000-0003-3052-0253</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459589/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459589/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53769,53771,79346,79347</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30973949$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Robboy, Stanley J.</contributor><creatorcontrib>Ategeka, John</creatorcontrib><creatorcontrib>Wasswa, Razack</creatorcontrib><creatorcontrib>Olwoch, Peter</creatorcontrib><creatorcontrib>Kakuru, Abel</creatorcontrib><creatorcontrib>Natureeba, Paul</creatorcontrib><creatorcontrib>Muehlenbachs, Atis</creatorcontrib><creatorcontrib>Kamya, Moses R</creatorcontrib><creatorcontrib>Dorsey, Grant</creatorcontrib><creatorcontrib>Rizzuto, Gabrielle</creatorcontrib><title>The prevalence of histologic acute chorioamnionitis among HIV infected pregnant women in Uganda and its association with adverse birth outcomes</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Preterm birth (PTB) is a leading cause of neonatal mortality and longer-term morbidity. Acute chorioamnionitis (ACA) is a common cause of PTB, however, there are limited data on the prevalence of ACA and its association with PTB in resource limited settings.
Data and samples came from a clinical trial evaluating novel strategies for the prevention of malaria in HIV infected pregnant women in Uganda. Women were enrolled between 12-28 weeks of gestation and followed through delivery. For each placenta delivered, three placental tissue types (membrane roll, umbilical cord and chorionic plate/villous parenchyma) were collected. Slides were assessed for diagnosis of maternal and fetal ACA by microscopic evaluation of neutrophilic infiltration using a standardized grading scale. The primary outcomes were PTB (<37 weeks), low birth weight (LBW, <2500 grams), and small-for-gestational age (SGA, birth weight <10th percentile for age). Univariate and multivariate logistic regression were used to estimate associations between 1) maternal characteristics (age, education, wealth, gravidity, gestational age at enrollment, placental malaria, anti-malarial prophylaxis treatment regimen, HIV disease parameters) and ACA, and 2) associations between ACA and adverse birth outcomes.
A total of 193 placentas were included in the analysis. The prevalence of maternal and fetal ACA was 44.5% and 28.0%, respectively. HIV infected women between 28-43 years of age had a higher risk of maternal ACA compared to those between 17-21 years of age (50.9% vs. 19.1%; aOR = 4.00 (1.10-14.5), p = 0.04) and the diagnosis of severe maternal ACA was associated with a significantly higher risk of PTB (28.6% vs. 6.0%; aOR = 6.04 (1.87-19.5), p = 0.003), LBW (33.3% vs. 9.4%; aOR = 4.86 (1.65-14.3); p = 0.004), and SGA (28.6% vs. 10.1%; aOR = 3.70 (1.20-11.4), p = 0.02). No maternal characteristics were significantly associated with fetal ACA and the diagnosis of fetal ACA was not associated with adverse birth outcomes.
Histological evidence of severe maternal ACA was associated with an increased risk of PTB, LBW, and SGA in HIV infected, pregnant Ugandan women.</description><subject>Acquired immune deficiency syndrome</subject><subject>Acute Disease</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Age</subject><subject>AIDS</subject><subject>Analysis</subject><subject>Archives & records</subject><subject>Babies</subject><subject>Biology and Life Sciences</subject><subject>Birth Weight</subject><subject>Cerebral palsy</subject><subject>Childbirth & labor</subject><subject>Chorioamnionitis</subject><subject>Chorioamnionitis - physiopathology</subject><subject>Clinical trials</subject><subject>Collaboration</subject><subject>Diagnosis</subject><subject>Disease prevention</subject><subject>Disease transmission</subject><subject>Double-Blind Method</subject><subject>Efavirenz</subject><subject>Evaluation</subject><subject>Female</subject><subject>Fetal Growth Retardation - etiology</subject><subject>Fetal Growth Retardation - pathology</subject><subject>Fetuses</subject><subject>Gestation</subject><subject>Gestational age</subject><subject>Health aspects</subject><subject>Health risks</subject><subject>HIV</subject><subject>HIV - isolation & purification</subject><subject>HIV Infections - complications</subject><subject>HIV Infections - epidemiology</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Infant mortality</subject><subject>Infant, Low Birth Weight</subject><subject>Infant, Newborn</subject><subject>Infant, Small for Gestational Age</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Infiltration</subject><subject>Inflammation</subject><subject>Laboratories</subject><subject>Leukocytes (neutrophilic)</subject><subject>Low birth weight</subject><subject>Malaria</subject><subject>Medical diagnosis</subject><subject>Medical treatment</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Membranes</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Neonates</subject><subject>Neutrophils</subject><subject>Newborn infants</subject><subject>Parenchyma</subject><subject>Pathology</subject><subject>Placenta</subject><subject>Pregnancy</subject><subject>Pregnancy Complications, Infectious - etiology</subject><subject>Pregnant women</subject><subject>Premature birth</subject><subject>Prevalence studies (Epidemiology)</subject><subject>Prophylaxis</subject><subject>Regression analysis</subject><subject>Risk</subject><subject>Small for gestational age</subject><subject>Tropical diseases</subject><subject>Uganda - epidemiology</subject><subject>Umbilical cord</subject><subject>Vector-borne diseases</subject><subject>Weight</subject><subject>Womens health</subject><subject>Young Adult</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk1Fv0zAQxyMEYmPwDRBYQkLw0GIncRq_IE0TsEqTJsG2V-vqnBNXiV1sp4NPwVfGXbupRXvgJYnPv__fuTtflr1mdMqKGfu0dKO30E9XzuKU5oxTXj_Jjpko8kmV0-Lp3vdR9iKEJaW8qKvqeXZUUDErRCmOsz9XHZKVxzX0aBUSp0lnQnS9a40ioMaIRHXOGweDNc6aaAKBwdmWnM9viLEaVcRmY9FasJHcugFtipPrFmwDJD2IiUkTglMGYvIgtyZ2BJo1-oBkYXxauTGqpAwvs2ca-oCvdu-T7Prrl6uz88nF5bf52enFRFUijxOd1wvgVDDeFAzKWb3QmgtRLVKKotS85JUqKMO0DRxRsZoVQpRUM1bOZlwVJ9nbre-qd0HuahlknqfKUFZXdSLmW6JxsJQrbwbwv6UDI-8CzrcSfDSqR8lyzSHHqlYaSr7QwJVGBgoawYTGJnl93p02LgZsFNrooT8wPdyxppOtW8uq5ILXIhl82Bl493PEEOVggsK-B4tu3P53RZkQRULf_YM-nt2OalPjZWqjS-eqjak85XVOq5zfUdNHqE1iOBiVLp42KX4g-HggSEzEX7GFMQQ5__H9_9nLm0P2_R7bIfSxC64fN9cpHILlFlTeheBRPxSZUbmZm_tqyM3cyN3cJNmb_QY9iO4HpfgLoMYVhw</recordid><startdate>20190411</startdate><enddate>20190411</enddate><creator>Ategeka, John</creator><creator>Wasswa, Razack</creator><creator>Olwoch, Peter</creator><creator>Kakuru, Abel</creator><creator>Natureeba, Paul</creator><creator>Muehlenbachs, Atis</creator><creator>Kamya, Moses R</creator><creator>Dorsey, Grant</creator><creator>Rizzuto, Gabrielle</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-3052-0253</orcidid></search><sort><creationdate>20190411</creationdate><title>The prevalence of histologic acute chorioamnionitis among HIV infected pregnant women in Uganda and its association with adverse birth outcomes</title><author>Ategeka, John ; Wasswa, Razack ; Olwoch, Peter ; Kakuru, Abel ; Natureeba, Paul ; Muehlenbachs, Atis ; Kamya, Moses R ; Dorsey, Grant ; Rizzuto, Gabrielle</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-f28ba50915d31a478bff5996b05394f5456c301e5d3a5eec18139940f114775c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>Acute Disease</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Age</topic><topic>AIDS</topic><topic>Analysis</topic><topic>Archives & records</topic><topic>Babies</topic><topic>Biology and Life Sciences</topic><topic>Birth Weight</topic><topic>Cerebral palsy</topic><topic>Childbirth & labor</topic><topic>Chorioamnionitis</topic><topic>Chorioamnionitis - 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etiology</topic><topic>Pregnant women</topic><topic>Premature birth</topic><topic>Prevalence studies (Epidemiology)</topic><topic>Prophylaxis</topic><topic>Regression analysis</topic><topic>Risk</topic><topic>Small for gestational age</topic><topic>Tropical diseases</topic><topic>Uganda - epidemiology</topic><topic>Umbilical cord</topic><topic>Vector-borne diseases</topic><topic>Weight</topic><topic>Womens health</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ategeka, John</creatorcontrib><creatorcontrib>Wasswa, Razack</creatorcontrib><creatorcontrib>Olwoch, Peter</creatorcontrib><creatorcontrib>Kakuru, Abel</creatorcontrib><creatorcontrib>Natureeba, Paul</creatorcontrib><creatorcontrib>Muehlenbachs, Atis</creatorcontrib><creatorcontrib>Kamya, Moses R</creatorcontrib><creatorcontrib>Dorsey, Grant</creatorcontrib><creatorcontrib>Rizzuto, Gabrielle</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ategeka, John</au><au>Wasswa, Razack</au><au>Olwoch, Peter</au><au>Kakuru, Abel</au><au>Natureeba, Paul</au><au>Muehlenbachs, Atis</au><au>Kamya, Moses R</au><au>Dorsey, Grant</au><au>Rizzuto, Gabrielle</au><au>Robboy, Stanley J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The prevalence of histologic acute chorioamnionitis among HIV infected pregnant women in Uganda and its association with adverse birth outcomes</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2019-04-11</date><risdate>2019</risdate><volume>14</volume><issue>4</issue><spage>e0215058</spage><epage>e0215058</epage><pages>e0215058-e0215058</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Preterm birth (PTB) is a leading cause of neonatal mortality and longer-term morbidity. Acute chorioamnionitis (ACA) is a common cause of PTB, however, there are limited data on the prevalence of ACA and its association with PTB in resource limited settings.
Data and samples came from a clinical trial evaluating novel strategies for the prevention of malaria in HIV infected pregnant women in Uganda. Women were enrolled between 12-28 weeks of gestation and followed through delivery. For each placenta delivered, three placental tissue types (membrane roll, umbilical cord and chorionic plate/villous parenchyma) were collected. Slides were assessed for diagnosis of maternal and fetal ACA by microscopic evaluation of neutrophilic infiltration using a standardized grading scale. The primary outcomes were PTB (<37 weeks), low birth weight (LBW, <2500 grams), and small-for-gestational age (SGA, birth weight <10th percentile for age). Univariate and multivariate logistic regression were used to estimate associations between 1) maternal characteristics (age, education, wealth, gravidity, gestational age at enrollment, placental malaria, anti-malarial prophylaxis treatment regimen, HIV disease parameters) and ACA, and 2) associations between ACA and adverse birth outcomes.
A total of 193 placentas were included in the analysis. The prevalence of maternal and fetal ACA was 44.5% and 28.0%, respectively. HIV infected women between 28-43 years of age had a higher risk of maternal ACA compared to those between 17-21 years of age (50.9% vs. 19.1%; aOR = 4.00 (1.10-14.5), p = 0.04) and the diagnosis of severe maternal ACA was associated with a significantly higher risk of PTB (28.6% vs. 6.0%; aOR = 6.04 (1.87-19.5), p = 0.003), LBW (33.3% vs. 9.4%; aOR = 4.86 (1.65-14.3); p = 0.004), and SGA (28.6% vs. 10.1%; aOR = 3.70 (1.20-11.4), p = 0.02). No maternal characteristics were significantly associated with fetal ACA and the diagnosis of fetal ACA was not associated with adverse birth outcomes.
Histological evidence of severe maternal ACA was associated with an increased risk of PTB, LBW, and SGA in HIV infected, pregnant Ugandan women.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30973949</pmid><doi>10.1371/journal.pone.0215058</doi><tpages>e0215058</tpages><orcidid>https://orcid.org/0000-0003-3052-0253</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2019-04, Vol.14 (4), p.e0215058-e0215058 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2209701868 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Acquired immune deficiency syndrome Acute Disease Adolescent Adult Age AIDS Analysis Archives & records Babies Biology and Life Sciences Birth Weight Cerebral palsy Childbirth & labor Chorioamnionitis Chorioamnionitis - physiopathology Clinical trials Collaboration Diagnosis Disease prevention Disease transmission Double-Blind Method Efavirenz Evaluation Female Fetal Growth Retardation - etiology Fetal Growth Retardation - pathology Fetuses Gestation Gestational age Health aspects Health risks HIV HIV - isolation & purification HIV Infections - complications HIV Infections - epidemiology Human immunodeficiency virus Humans Infant mortality Infant, Low Birth Weight Infant, Newborn Infant, Small for Gestational Age Infections Infectious diseases Infiltration Inflammation Laboratories Leukocytes (neutrophilic) Low birth weight Malaria Medical diagnosis Medical treatment Medicine Medicine and Health Sciences Membranes Morbidity Mortality Neonates Neutrophils Newborn infants Parenchyma Pathology Placenta Pregnancy Pregnancy Complications, Infectious - etiology Pregnant women Premature birth Prevalence studies (Epidemiology) Prophylaxis Regression analysis Risk Small for gestational age Tropical diseases Uganda - epidemiology Umbilical cord Vector-borne diseases Weight Womens health Young Adult |
| title | The prevalence of histologic acute chorioamnionitis among HIV infected pregnant women in Uganda and its association with adverse birth outcomes |
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