{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T14:09:41Z","timestamp":1792850981444,"version":"4.5.0"},"reference-count":117,"publisher":"Walter de Gruyter GmbH","issue":"5","funder":[{"name":"National Institutes of HealthU.S. Department of Health and Human Services","award":["Unassigned"],"award-info":[{"award-number":["Unassigned"]}]},{"name":"National Institutes of HealthU.S. Department of Health and Human Services","award":["Unassigned"],"award-info":[{"award-number":["Unassigned"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,6,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpm-2021-0681_abs_001\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To determine whether placental vascular pathology and impaired placental exchange due to maturational defects are involved in the etiology of spontaneous preterm labor and delivery in cases without histologic acute chorioamnionitis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2021-0681_abs_002\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a retrospective, observational study. Cases included pregnancies that resulted in spontaneous preterm labor and delivery (&lt;37 weeks), whereas uncomplicated pregnancies that delivered fetuses at term (\u226537\u201342 weeks of gestation) were selected as controls. Placental histological diagnoses were classified into three groups: lesions of maternal vascular malperfusion, lesions of fetal vascular malperfusion, and placental microvasculopathy, and the frequency of each type of lesion in cases and controls was compared. Moreover, we specifically searched for villous maturational abnormalities in cases and controls. Doppler velocimetry of the umbilical and uterine arteries were performed in a subset of patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2021-0681_abs_003\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were 184 cases and 2471 controls, of which 95 and 1178 had Doppler studies, respectively. The frequency of lesions of maternal vascular malperfusion was greater in the placentas of patients with preterm labor than in the control group [14.1% (26\/184) vs. 8.8% (217\/2471) (p=0.023)]. Disorders of villous maturation were more frequent in the group with preterm labor than in the control group: 41.1% (39\/95) [delayed villous maturation in 31.6% (30\/95) vs. 2.5% (13\/519) in controls and accelerated villous maturation in 9.5% (9\/95) vs. none in controls].<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpm-2021-0681_abs_004\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Maturational defects of placental villi were associated with approximately 41% of cases of unexplained spontaneous preterm labor and delivery without acute inflammatory lesions of the placenta and with delivery of appropriate-for-gestational-age fetuses.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpm-2021-0681","type":"journal-article","created":{"date-parts":[[2022,3,5]],"date-time":"2022-03-05T00:33:21Z","timestamp":1646440401000},"page":"553-566","source":"Crossref","is-referenced-by-count":28,"title":["The role of the placenta in spontaneous preterm labor and delivery with intact membranes"],"prefix":"10.1515","volume":"50","author":[{"given":"Sunil","family":"Jaiman","sequence":"first","affiliation":[{"name":"Perinatology Research Branch , Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research , Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health , U.S. Department of Health and Human Services (NICHD\/NIH\/DHHS) , Bethesda, MD , Detroit , MI , USA"},{"name":"Department of Pathology , Wayne State University School of Medicine , Detroit , MI , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Romero","sequence":"additional","affiliation":[{"name":"Perinatology Research Branch , Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research , Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health , U.S. Department of Health and Human Services (NICHD\/NIH\/DHHS) , Bethesda, MD , Detroit , MI , USA"},{"name":"Department of Obstetrics and Gynecology , University of Michigan , Ann Arbor , MI , USA"},{"name":"Department of Epidemiology and Biostatistics , Michigan State University , East Lansing , MI , USA"},{"name":"Center for Molecular Medicine and Genetics , Wayne State University , Detroit , MI , USA"},{"name":"Detroit Medical Center , Detroit , MI , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaurav","family":"Bhatti","sequence":"additional","affiliation":[{"name":"Perinatology Research Branch , Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research , Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health , U.S. Department of Health and Human Services (NICHD\/NIH\/DHHS) , Bethesda, MD , Detroit , MI , USA"},{"name":"Department of Biomedical Engineering , Wayne State University College of Engineering , Detroit , MI , USA"},{"name":"Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunjung","family":"Jung","sequence":"additional","affiliation":[{"name":"Perinatology Research Branch , Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research , Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health , U.S. Department of Health and Human Services (NICHD\/NIH\/DHHS) , Bethesda, MD , Detroit , MI , USA"},{"name":"Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Gotsch","sequence":"additional","affiliation":[{"name":"Perinatology Research Branch , Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research , Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health , U.S. Department of Health and Human Services (NICHD\/NIH\/DHHS) , Bethesda, MD , Detroit , MI , USA"},{"name":"Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manaphat","family":"Suksai","sequence":"additional","affiliation":[{"name":"Perinatology Research Branch , Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research , Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health , U.S. Department of Health and Human Services (NICHD\/NIH\/DHHS) , Bethesda, MD , Detroit , MI , USA"},{"name":"Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dahiana M.","family":"Gallo","sequence":"additional","affiliation":[{"name":"Perinatology Research Branch , Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research , Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health , U.S. Department of Health and Human Services (NICHD\/NIH\/DHHS) , Bethesda, MD , Detroit , MI , USA"},{"name":"Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tinnakorn","family":"Chaiworapongsa","sequence":"additional","affiliation":[{"name":"Perinatology Research Branch , Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research , Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health , U.S. Department of Health and Human Services (NICHD\/NIH\/DHHS) , Bethesda, MD , Detroit , MI , USA"},{"name":"Department of Obstetrics and Gynecology , Wayne State University School of Medicine , Detroit , MI , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Kadar","sequence":"additional","affiliation":[{"name":"Cranbury , NJ , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2022,3,4]]},"reference":[{"key":"2023040100573184427_j_jpm-2021-0681_ref_001","doi-asserted-by":"crossref","unstructured":"Chawanpaiboon, S, Vogel, JP, Moller, AB, Lumbiganon, P, Petzold, M, Hogan, D, et al.. 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