title: Both acute and chronic placental inflammation are overrepresented in term stillbirths: a case-control study.
abstract: OBJECTIVE
  To elucidate differences in the frequency and severity of acute chorioamnionitis (CAM) and chronic villitis in placentas from stillborns compared with liveborns at term and to evaluate other risk factors and placental findings.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  All delivery wards in major Stockholm area. Population or Sample. Placentas from stillborn/case (n = 126) and liveborn/control (n = 273) neonates were prospectively collected between 2002 and 2005.
  
  
  METHODS
  CAM was assessed on a three-grade scale based on the presence and distribution of polymorphonuclear leucocytes in the chorion/amnion. The presence of vasculitis and funisitis was recorded separately. Chronic villitis was diagnosed by the presence of mononuclear cells in the villous stroma. Relevant clinical data were collected from a specially constructed, web-based database. The statistic analyses were performed using multivariable logistic regression.
  
  
  RESULTS
  CAM (especially severe, AOR: 7.39 CI: 3.05-17.95), villous immaturity (AOR: 7.17 CI: 2.66-19.33), villitis (<1 % AOR: 4.31 CI: 1.16-15.98; ≥ 1 %, AOR: 3.87 CI: 1.38-10.83), SGA (AOR: 7.52 CI: 3.06-18.48), and BMI >24.9 (AOR: 2.06 CI: 1.21-3.51) were all connected to an elevated risk of term stillbirth.
  
  
  CONCLUSIONS
  We found that CAM, chronic villitis, villous immaturity, SGA, and maternal overweight, but not vasculitis or funisitis are independently associated with risk for stillbirth at term.
authors.affiliation: Department of Obstetrics and Gynecology, Karolinska University Hospital, Solna and Karolinska Institutet, 171 76 Stockholm, Sweden. ingela.hulthen-varli@karolinska.se
authors.forename: Ingela
authors.initials: I
authors.lastname: Hulthén Varli
authors.forename: Karin
authors.initials: K
authors.lastname: Petersson
authors.forename: Marius
authors.initials: M
authors.lastname: Kublickas
authors.forename: Nikos
authors.initials: N
authors.lastname: Papadogiannakis
mesh_terms: D000208:Acute Disease; D000328:Adult; D016022:Case-Control Studies; D002821:Chorioamnionitis / Q000175:diagnosis / Q000453:epidemiology; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D015999:Multivariate Analysis; D010922:Placenta Diseases / Q000175:diagnosis / Q000453:epidemiology*; D011247:Pregnancy; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D050497:Stillbirth; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult