{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:23:14Z","timestamp":1787271794362,"version":"build-2736575974"},"reference-count":25,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Placental pathology is a leading contributor to stillbirth; however, whether placental histopathological lesions differ according to parity in stillbirth remains poorly defined. The aim of the present study is to evaluate the association between parity and placental histopathological lesions in singleton pregnancies ending in antepartum stillbirth.<\/jats:p>\n                  <jats:p>Retrospective review of placentas from singleton antepartum stillbirths, in nonmacerated and morphologically normal fetuses, was performed blinded to clinical data. Placental lesions were classified per international consensus criteria and compared between nulliparous and parous women.<\/jats:p>\n                  <jats:p>Placental histopathological abnormalities were identified in the vast majority of cases in both nulliparous and parous women (&gt;94%). The prevalence of maternal vascular malperfusion, fetal vascular malperfusion, delayed villous maturation, and ascending intrauterine infection did not differ between groups. In contrast, villitis of unknown etiology (VUE) was significantly more frequent in parous than in nulliparous women (13.2 vs. 1.6%). All VUE cases represented high-grade lesions and were frequently associated with low birth weight.<\/jats:p>\n                  <jats:p>Among placental lesions in stillbirth, high-grade VUE shows an association with parity. Systematic placental histopathology evaluation may enhance the etiological classification of stillbirth, providing potential mechanistic insights. This knowledge can support more accurate recurrence risk stratification and individualized counseling.<\/jats:p>","DOI":"10.1055\/a-2936-5508","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T23:13:14Z","timestamp":1786576394000},"source":"Crossref","is-referenced-by-count":0,"title":["Unraveling the Role of Parity in Placentas from Antepartum Stillbirth"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7808-7578","authenticated-orcid":false,"given":"Laura","family":"Avagliano","sequence":"additional","affiliation":[{"name":"University of Milan, Lombardy, Italy","place":["Milan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0568-9892","authenticated-orcid":false,"given":"Martina","family":"Benuzzi","sequence":"additional","affiliation":[{"name":"University of Modena and Reggio Emilia, Italy","place":["Modena"],"department":["Mother-Infant and Adult Department of Medical and Surgical Sciences, Obstetrics and Gynecology Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Monari","sequence":"additional","affiliation":[{"name":"University of Modena and Reggio Emilia, Italy","place":["Modena"],"department":["Mother-Infant and Adult Department of Medical and Surgical Sciences, Obstetrics and Gynecology Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Guariglia","sequence":"additional","affiliation":[{"name":"University of Modena and Reggio Emilia, Italy","place":["Modena"],"department":["Mother-Infant and Adult Department of Medical and Surgical Sciences, Obstetrics and Gynecology Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"La Marca","sequence":"additional","affiliation":[{"name":"University of Modena and Reggio Emilia, Italy","place":["Modena"],"department":["Mother-Infant and Adult Department of Medical and Surgical Sciences, Obstetrics and Gynecology Unit"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Botticelli","sequence":"additional","affiliation":[{"name":"University of Modena and Reggio Emilia, Emilia-Romagna, Italy","place":["Modena"],"department":["Department of Medical and Surgical Sciences for Children and Adults"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaetano","family":"Bulfamante","sequence":"additional","affiliation":[{"name":"University of Milan, Lombardy, Italy","place":["Milan"],"department":["Department of Biomedical, Surgical and Dental Sciences"]},{"name":"Toma Advanced Biomedical Assays SpA, Lombardy, Italy","place":["Busto Arsizio"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.ajog.2024.02.304","article-title":"Association of previous stillbirth with subsequent perinatal outcomes: a systematic review and meta-analysis of cohort studies","volume":"231","author":"X Deng","year":"2024","journal-title":"Am J Obstet Gynecol"},{"key":"ref2","volume-title":"Improving maternal and newborn health and survival and reducing stillbirth: progress report 2023","author":"World Health Organization","year":"2023"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1002\/uog.16019","article-title":"Stillbirth and intrauterine fetal death: role of routine histopathological placental findings to determine cause of death","volume":"48","author":"J Man","year":"2016","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1007\/s00404-024-07522-1","article-title":"Identifying causes and associated factors of stillbirths using autopsy of the fetus and placenta","volume":"311","author":"E Kedar Sade","year":"2025","journal-title":"Arch Gynecol Obstet"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.placenta.2024.09.015","article-title":"Placental lesions in stillbirth following the Amsterdam consensus: a systematic review and meta-analysis","volume":"158","author":"B F Narice","year":"2024","journal-title":"Placenta"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"151871","DOI":"10.1016\/j.semperi.2023.151871","article-title":"Stillbirth and the placenta","volume":"48","author":"J A Waller","year":"2024","journal-title":"Semin Perinatol"},{"issue":"07","key":"ref7","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1111\/apm.12842","article-title":"The structure and utility of the placental pathology report","volume":"126","author":"G Turowski","year":"2018","journal-title":"APMIS"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1080\/01443610802716042","article-title":"Can post-mortem examination of the placenta help determine the cause of stillbirth?","volume":"29","author":"A E Heazell","year":"2009","journal-title":"J Obstet Gynaecol"},{"issue":"07","key":"ref9","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1111\/apm.12796","article-title":"Placental pathologic lesions with a significant recurrence risk - what not to miss!","volume":"126","author":"A Chen","year":"2018","journal-title":"APMIS"},{"issue":"02","key":"ref10","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1111\/1471-0528.14906","article-title":"Risk of stillbirth, preterm delivery, and fetal growth restriction following exposure in a previous birth: systematic review and meta-analysis","volume":"125","author":"E Malacova","year":"2018","journal-title":"BJOG"},{"issue":"01","key":"ref11","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1053\/sper.2002.29841","article-title":"The epidemiology of stillbirth","volume":"26","author":"S Cnattingius","year":"2002","journal-title":"Semin Perinatol"},{"issue":"01","key":"ref12","first-page":"1","article-title":"[Embryo and fetal pathology in routine diagnostics: what has changed and what needs to be changed]","volume":"98","author":"E Fulcheri","year":"2006","journal-title":"Pathologica"},{"issue":"07","key":"ref13","doi-asserted-by":"crossref","first-page":"698","DOI":"10.5858\/arpa.2015-0225-CC","article-title":"Sampling and definitions of placental lesions: Amsterdam Placental Workshop Group consensus statement","volume":"140","author":"T Y Khong","year":"2016","journal-title":"Arch Pathol Lab Med"},{"issue":"10","key":"ref14","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1016\/j.humpath.2007.05.025","article-title":"Villitis of unknown etiology: noninfectious chronic villitis in the placenta","volume":"38","author":"R W Redline","year":"2007","journal-title":"Hum Pathol"},{"issue":"01","key":"ref15","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1111\/1471-0528.17844","article-title":"Care of late intrauterine fetal death and stillbirth: Green-top Guideline No. 55","volume":"132","author":"C Burden","year":"2025","journal-title":"BJOG"},{"issue":"02","key":"ref16","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1093\/ajcp\/aqaa035","article-title":"The burden of placental histopathology in stillbirths associated with maternal obesity","volume":"154","author":"L Avagliano","year":"2020","journal-title":"Am J Clin Pathol"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"825075","DOI":"10.3389\/fimmu.2022.825075","article-title":"Chronic inflammatory placental disorders associated with recurrent adverse pregnancy outcome","volume":"13","author":"E F Cornish","year":"2022","journal-title":"Front Immunol"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"1656438","DOI":"10.3389\/fmed.2025.1656438","article-title":"Villitis of unknown etiology is a placental pathology associated with pregnancy complication: a systematic review and meta-analysis","volume":"12","author":"X Zhang","year":"2025","journal-title":"Front Med (Lausanne)"},{"issue":"04","key":"ref19","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1016\/j.ajpath.2015.12.010","article-title":"Characterizing villitis of unknown etiology and inflammation in stillbirth","volume":"186","author":"H Derricott","year":"2016","journal-title":"Am J Pathol"},{"issue":"01","key":"ref20","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1053\/j.semperi.2014.10.002","article-title":"The clinical implications of placental diagnoses","volume":"39","author":"R W Redline","year":"2015","journal-title":"Semin Perinatol"},{"issue":"02","key":"ref21","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.ajog.2022.08.010","article-title":"Placental pathology is necessary to understand common pregnancy complications and achieve an improved taxonomy of obstetrical disease","volume":"228","author":"R W Redline","year":"2023","journal-title":"Am J Obstet Gynecol"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"103438","DOI":"10.1016\/j.jri.2021.103438","article-title":"Chronic villitis of unknown etiology (VUE): obstetrical features, outcome and treatment","volume":"148","author":"A Mekinian","year":"2021","journal-title":"J Reprod Immunol"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.placenta.2024.12.020","article-title":"Priority setting partnership on placental pathology: consensus recommendations for placental research","volume":"160","author":"M C Marijnen","year":"2025","journal-title":"Placenta"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.placenta.2025.02.007","article-title":"Stillbirth at term in Iceland: causes of death and patterns of placental injury","volume":"162","author":"R I Bjarnadottir","year":"2025","journal-title":"Placenta"},{"issue":"12","key":"ref25","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1016\/j.molmed.2024.08.002","article-title":"Incorporating placental pathology into clinical care and research","volume":"30","author":"D Roberts","year":"2024","journal-title":"Trends Mol Med"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2936-5508.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T23:24:25Z","timestamp":1787268265000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2936-5508"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,12]]},"references-count":25,"URL":"https:\/\/doi.org\/10.1055\/a-2936-5508","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,8,12]]},"published":{"date-parts":[[2026,8,12]]}}}