Title: 560: Placental histopathology correlated with corticotropin releasing hormone and birth outcomes
Abstract: To evaluate whether placental histopathology associated with acute inflammation or uteroplacental insufficiency (UPI) is associated with placental corticotropin releasing hormone (pCRH) and birth outcomes. A secondary analysis of 112 singleton pregnancies between 24 and 34 weeks' gestation who received betamethasone (BMZ) for various indications, including preterm labor, short cervix, preterm premature rupture of membranes, placental abruption, hypertension, or intrauterine growth restriction. Maternal blood was collected prior to BMZ administration and samples assayed for pCRH levels. All placentas were examined by two pathologists, one with subspecialty training in placental pathology. Histopathologic findings associated with inflammatory conditions including chorionitis, choramnionitis, choramnionitis involving the basal plate, microabscesses, funisitis, and vasculitis, or findings associated with UPI, such as accelerated villous maturation, perilous fibrin deposition, infarction, chorangiosis, nucleated red blood cells, and increased syncytial knots were compared against subjects without placental findings. Outcomes included pretreatment gestational age-adjusted pCRH levels and birth outcomes. Thirty-six subjects had histopathology characteristic of inflammation, and 38 had findings of UPI. Thirty-eight subjects exhibited no placental abnormalities. Placental CRH levels were significantly higher in the UPI group compared both to subjects with inflammatory or no histopathology, p<0.01 and p<0.01, respectively. While subjects with inflammatory histopathology delivered significantly earlier compared to those with UPI or no placental findings, p=0.02 and p=0.03, their infants had significantly higher birthweight percentile compared to subjects with UPI or no histopathology, p=0.02 and p=0.02, respectively. Subjects with UPI demonstrate significantly elevated pCRH levels. Despite later mean gestational age at birth, the infants of these subjects are of significantly lower birthweight percentile compared to subjects with inflammatory histopathology.View Large Image Figure ViewerDownload Hi-res image Download (PPT)