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This study was undertaken to investigate the incidence and associations of placental villitis of unknown origin or etiology (VUE). Five hundred nine placentas from women delivered of small- for- gestational- age infants (SGAP) and 529 placentas from women delivering infants with birth weights appropriate for gestational age (AGAP) were examined prospectively for VUE as part of a population- based case control study of SGA infants at term. VUE was found in 17.3% of SGAP and 11.7% of AGAP and was an independent risk factor for SGA (adjusted odds ratio 2.35, 95% CI 1.55- 3.56). Villitis in conjunction with maternal hypertension increased the risk of SGA substantially (adjusted odds ratio 17.7, 95% CI 3.6- 86.9). A study of a wide range of pregnancy- related factors found no significant associations with VUE in AGAP. In contrast, VUE in SGAP had significant associations after multivariate analysis with maternal body mass index, multigravidity, ethnicity, and 1 index of maternal infection. VUE is an independent risk factor for SGA at term. Maternal factors influence this association, possibly by modifying a systemic effect on fetal growth of villous inflammation at commonly occurring defects in the maternal- fetal immune barrier.
This study was undertaken to investigate the incidence and associations of placental villitis of unknown origin or etiology (VUE). Five hundred nine placentas from women delivered small-for-gestational-age infants (SGAP) and 529 placentas from women delivered infants with birth weights appropriate for gestational age (AGAP) were examined prospectively for VUE as part of a population-based case control study of SGA infants at term. VUE was found in 17.3% of SGAP and 11.7% of AGAP and was an independent risk factor for SGA (adjusted odds ratio 2.35, 95% CI 1.55-3.56). Villitis in conjunction with maternal hypertension increased the risk of SGA substantially (adjusted odds ratio 17.7, 95% CI 3.6-86.9). A study of a wide range of pregnancy-related factors found no significant associations with VUE in AGAP. In contrast, VUE in SGAP had a significant associations after multivariate analysis with maternal body mass index, multigravidity, ethnicity, and 1 index of maternal infection. VUE is an independent risk factor for this association, possibly by modifying a systemic effect on fetal growth of villous inflammation at commonly occurring defects in the maternal-fetal immune barrier.