title: Correlation between Clinical, Placental Histology and Microbiological Findings in Spontaneous Preterm Births.
abstract: OBJECTIVE
  To examine the occurrence of chorioamnionitis and abruption among women who had a spontaneous preterm birth (SPTB), the correlation between clinical and placental findings, and the impact of these complications on neonatal outcome after delivery.
  
  
  METHODS
  This was a retrospective case-control study conducted between 2008 and 2012 at a single teaching hospital. The study group included all women who had an SPTB (23-36 weeks). Placentas were cultured and underwent histological examination.
  
  
  RESULTS
  A total of 478 women were included. The mean gestational age at delivery was 32.6 ± 3.1 weeks. Overall, 260 (54.4%) women had either clinical and/or histological abruption or chorioamnionitis. Clinical chorioamnionitis was diagnosed before birth in 14 (2.9%) women, while histological chorioamnionitis (HCA) in 84 (17.4%). Overall, 38 neonates had infection. Placental cultures were negative in 65.8% (25/38) of these neonates, and in 77.1% (27/38), HCA was ruled out. Logistic regression analysis revealed that neonatal morbidity and mortality were correlated with gestational age at delivery (p = 0.02), not with placental pathology (p = 0.08).
  
  
  CONCLUSIONS
  Half of the women with PTB had clinical or histological abruption, chorioamnionitis or both. A partial correlation was found between clinical and placental findings. The main determinant of neonatal outcome was gestational age at delivery and not placental findings.
authors.affiliation: Rappaport Faculty of Medicine, Technion, Haifa, Israel.
authors.forename: Gali
authors.initials: G
authors.lastname: Garmi
authors.forename: Marina
authors.initials: M
authors.lastname: Okopnik
authors.forename: Yoram
authors.initials: Y
authors.lastname: Keness
authors.forename: Noah
authors.initials: N
authors.lastname: Zafran
authors.forename: Elad
authors.initials: E
authors.lastname: Berkowitz
authors.forename: Raed
authors.initials: R
authors.lastname: Salim
mesh_terms: D000037:Abruptio Placentae / Q000453:epidemiology / Q000382:microbiology / Q000473:pathology*; D016022:Case-Control Studies; D002821:Chorioamnionitis / Q000453:epidemiology / Q000382:microbiology / Q000473:pathology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D010920:Placenta / Q000382:microbiology / Q000473:pathology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000209:etiology / Q000401:mortality* / Q000473:pathology; D012189:Retrospective Studies