title: Racial disparity in placental pathology in the collaborative perinatal project.
abstract: OBJECTIVE
  There is substantial disparity in perinatal outcomes between white and African-American women, but the underlying biological mechanisms are poorly understood. The placenta is the principal metabolic, respiratory, excretory, and endocrine organ of the fetus. We studied the association between maternal race and types and severity of placental pathology.
  
  
  METHODS
  Using data from the U.S. Collaborative Perinatal Project (1959-1966), we studied 32,295 African-American and white women with singleton births. CPP pathologists conducted detailed placental examinations following a standard protocol with quality control procedures. Logistic regression modeling was used to test the association between race and placental pathology adjusting for potential confounders.
  
  
  RESULTS
  Compared to white women, African-American women had a higher risk of fetal neutrophilic infiltration (adjusted odds ratio [aOR], 1.2; 95% confidence interval [CI], 1.0-1.4), and 1.5-fold higher risk of low placental weight (95% CI, 1.3-1.7). However, various placental vascular lesions were significantly less common in African-American women, including infarcts and thrombosis in the cut surface, villous infarcts in the intervillous space, emergence of stromal fibrosis and Langerhans layer in the terminal villi, old hemorrhage in the maternal surface, thrombosis in the intervillous space, and calcification throughout the cut surface (aOR ranging from 0.5 to 0.8). Similar patterns were observed in pregnancies with pregnancy associated hypertension, small-for-gestational-age, and preterm birth.
  
  
  CONCLUSIONS
  As compared with white women, African-American had higher prevalence of inflammatory lesions but lower prevalence of vascular lesions in placental pathology.
authors.affiliation: MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong UniversityShanghai, China; Department of Neonatology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong UniversityShanghai, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Chen
authors.affiliation: MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong UniversityShanghai, China; Department of Pediatrics, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong UniversityShanghai, China.
authors.forename: Lisu
authors.initials: L
authors.lastname: Huang
authors.affiliation: Departments of Pathology and Bio-Bank, The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University Shanghai, China.
authors.forename: Huijuan
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Pediatrics, Nationwide Children's Hospital, College of Medicine, The Ohio State University Columbus, Ohio, U.S.
authors.forename: Mark
authors.initials: M
authors.lastname: Klebanoff
authors.affiliation: Department of Obstetrics, Xin Hua Hospital, School of Medicine, Shanghai Jiao Tong University Shanghai, China.
authors.forename: Zujing
authors.initials: Z
authors.lastname: Yang
authors.affiliation: MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University Shanghai, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000328:Adult; D001741:Black or African American; D015331:Cohort Studies; D005260:Female; D006801:Humans; D010922:Placenta Diseases / Q000453:epidemiology*; D011247:Pregnancy; D015995:Prevalence; D011446:Prospective Studies; D044465:White People; D055815:Young Adult
keywords: Race; placental pathology; pregnancy associated hypertension; preterm birth; small for gestational age
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