title: "Trophoblast islands of the chorionic connective tissue" (TICCT): a novel placental histologic feature.
abstract: BACKGROUND
  We found isolated or clustered trophoblasts in the chorionic connective tissue of the extraplacental membranes, and defined this novel histologic feature as the "trophoblast islands of the chorionic connective tissue" (TICCT). This study was conducted to determine the clinical significance of TICCT.
  
  
  METHODS
  Immunohistochemistry for cytokeratin-7 was performed on the chorioamniotic membranes (N = 2155) obtained from singleton pregnancies of 1199 uncomplicated term and 956 preterm deliveries. The study groups comprised 1236 African-American and 919 Hispanic women. Gestational age ranged from 24(+0) weeks to 41(+6) weeks. Multiple logistic regression analysis was performed to investigate the magnitude of association between patient characteristics and the presence of TICCT.
  
  
  RESULTS
  The likelihood of TICCT was significantly associated with advancing gestational age both in term (OR: 1.29, 95% CI: 1.16-1.45, p < 0.001) and preterm deliveries (OR: 1.19, 95% CI: 1.07-1.32, p = 0.001) . Hispanic women were less likely than African-American women to have TICCT across gestation in term (OR: 0.23, 95% CI: 0.18-0.31, p < 0.001) and preterm pregnancies (OR: 0.41, 95% CI: 0.29-0.58, p < 0.001). Women with a female fetus were significantly more likely to have TICCT than women with a male fetus, in both term (OR: 1.64, 95% CI: 1.28-2.11, p < 0.001) and preterm gestations (OR: 2.04, 95% CI: 1.46-2.85, p < 0.001). TICCT was 40% less frequent in the presence of chronic placental inflammation [term (OR: 0.60, 95% CI: 0.45-0.81, p = 0.001) and preterm gestations (OR: 0.58, 95% CI: 0.40-0.84, p = 0.003)] and in parous women at term (OR: 0.60, 95% CI: 0.44-0.81, p = 0.001).
  
  
  CONCLUSIONS
  Our findings suggest that the duration of pregnancy, fetal sex, and parity may influence the behavior of extravillous trophoblast and placental mesenchymal cells.
authors: Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, MD, USA.
authors: J-S
authors: JS
authors: Hong
authors: R
authors: R
authors: Romero
authors: J P
authors: JP
authors: Kusanovic
authors: J-S
authors: JS
authors: Kim
authors: J
authors: J
authors: Lee
authors: M
authors: M
authors: Jin
authors: H
authors: H
authors: El Azzamy
authors: D-C
authors: DC
authors: Lee
authors: V
authors: V
authors: Topping
authors: S
authors: S
authors: Ahn
authors: S
authors: S
authors: Jacques
authors: F
authors: F
authors: Qureshi
authors: T
authors: T
authors: Chaiworapongsa
authors: S S
authors: SS
authors: Hassan
authors: S J
authors: SJ
authors: Korzeniewski
authors: N G
authors: NG
authors: Than
authors: C J
authors: CJ
authors: Kim
mesh_terms: D001741:Black or African American; D002677:Chile; D002823:Chorion / Q000473:pathology*; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D053552:Keratin-7 / Q000032:analysis; D008297:Male; D008824:Michigan; D010298:Parity; D010920:Placenta / Q000473:pathology; D010922:Placenta Diseases / Q000473:pathology*; D011247:Pregnancy; D047928:Premature Birth / Q000473:pathology; D012737:Sex Factors; D014327:Trophoblasts / Q000473:pathology*; D044465:White People
chemical_list: D053552:Keratin-7