title: Maternal Income during Pregnancy is Associated with Chronic Placental Inflammation at Birth.
abstract: ObjectiveThis study aims to examine whether maternal household income is associated with histological evidence of chronic placental inflammation.Study DesignA total of 152 participants completed surveys of household income and consented to placenta collection at delivery and postpartum chart review for birth outcomes. Placental inflammatory lesions were evaluated via histological examination of the membranes, basal plate, and villous parenchyma by a single, experienced pathologist. Associations between household income and the presence of inflammatory lesions were adjusted for known perinatal risk factors.ResultsOverall, 45% of participants reporting household income below $30,000/y had chronic placental inflammation, compared with 25% of participants reporting income above $100,000 annually (odds ratio [OR] = 4.23, 95% confidence interval [CI] = 1.25, 14.28;p= 0.02). Middle-income groups showed intermediate rates of chronic inflammatory lesions, at 40% for those reporting $30,000 and 50,000 (OR = 3.60, 95% CI = 1.05, 12.53;p= 0.04) and 38% for those reporting $50,000 to 100,000 (OR = 1.57, 95% CI = 0.60, 4.14;p= 0.36). Results remained significant after adjustment for maternal age, race, and marital status.ConclusionChronic placental inflammation is associated with maternal household income. Greater occurrence of placental lesions in low-income mothers may arise from a systemic inflammatory response to social and physical environmental factors.
authors.affiliation: Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Evanston, Illinois.
authors.forename: Lauren S
authors.initials: LS
authors.lastname: Keenan-Devlin
authors.affiliation: Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Linda M
authors.initials: LM
authors.lastname: Ernst
authors.affiliation: Department of Psychology and Institute for Policy Research, Northwestern University, Evanston, Illinois.
authors.forename: Kharah M
authors.initials: KM
authors.lastname: Ross
authors.affiliation: Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Evanston, Illinois.
authors.forename: Sameen
authors.initials: S
authors.lastname: Qadir
authors.affiliation: Division of Maternal-Fetal Medicine and Center for Healthcare Studies, Department of Obstetrics and Gynecology, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: William A
authors.initials: WA
authors.lastname: Grobman
authors.affiliation: Department of Pediatrics, Northwestern University Feinberg School of Medicine, Center for Healthcare Studies-Institute for Public Health and Medicine, Greenville, South Carolina.
authors.forename: Jane L
authors.initials: JL
authors.lastname: Holl
authors.affiliation: Department of Obstetrics and Gynecology, Greenville Hospital System University Medical Center, Greenville, South Carolina.
authors.forename: Amy
authors.initials: A
authors.lastname: Crockett
authors.affiliation: Department of Psychology and Institute for Policy Research, Northwestern University, Evanston, Illinois.
authors.forename: Gregory E
authors.initials: GE
authors.lastname: Miller
authors.affiliation: Department of Obstetrics and Gynecology, NorthShore University HealthSystem, University of Chicago Pritzker School of Medicine; Northwestern University Center for Healthcare Studies-Institute for Public Health and Medicine, Evanston, Illinois.
authors.forename: Ann E B
authors.initials: AEB
authors.lastname: Borders
mesh_terms: D001724:Birth Weight; D002821:Chorioamnionitis / Q000453:epidemiology* / Q000473:pathology; D002908:Chronic Disease; D005260:Female; D005865:Gestational Age; D006801:Humans; D007182:Income; D009035:Mothers / Q000706:statistics & numerical data*; D036801:Parturition; D011247:Pregnancy