Placental histology for targeted risk assessment of recurrent spontaneous preterm birth

Abstract

Introduction: Placenta is an important part that connects two different circulatory systems to facilitate nutrient and gas exchange, hormone production and immunological regulation of pregnancy. Objectives: The basic aim of the study is to find the placental histology for targeted risk assessment of recurrent spontaneous preterm birth. Methodology of the study: This study involved a retrospective analysis conducted at Al-Yamama Hospital, Riyadh Second Health Cluster, KSA from June 2022 to June 2023. This study consisted of placental histology findings from a cohort of 550 pregnant women with a history of recurrent spontaneous preterm birth (SPTB). The cohort was identified from obstetric databases spanning a specified time frame, with inclusion criteria consisting of women who experienced two or more previous spontaneous preterm deliveries before 37 weeks of gestation. Results: Data were collected from 550 patients. Mean age was 28.01± 4.23 years. Average gestational age at delivery of 32.7±3.12 weeks and a mean BMI of 25.3± 3 kg/m2. Obstetric characteristics revealed a history of 2.2± 0.5 previous preterm births, 1.8± 0.7 term births, 0.5± 0.3 miscarriages, and 0.1± 0.2 stillbirths. Among the placental histology parameters assessed, abnormal villous morphology was prevalent in 65% of cases and significantly associated with recurrent spontaneous preterm birth (SPTB) with a p-value of 0.001. Chronic villitis was observed in 30% of cases, while acute chorioamnionitis was present in 20%, both showing a significant association with recurrent SPTB at p-values of 0.05. Conclusion: Placental histology serves as a valuable tool for predicting the risk of recurrent spontaneous preterm birth (SPTB) and its associated neonatal outcomes and it helps in enabling early identification of high-risk pregnancies and personalized interventions to improve maternal and neonatal outcomes.