The prevalence of histologic acute chorioamnionitis among HIV infected pregnant women in Uganda and its association with adverse birth outcomes

• Published in: PloS one 2019-04, Vol.14 (4), p.e0215058-e0215058
• Main Authors: Ategeka, John, Wasswa, Razack, Olwoch, Peter, Kakuru, Abel, Natureeba, Paul, Muehlenbachs, Atis, Kamya, Moses R, Dorsey, Grant, Rizzuto, Gabrielle
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Acute Disease; Adolescent; Adult; Age; AIDS; Analysis; Archives & records; Babies; Biology and Life Sciences; Birth Weight; Cerebral palsy; Childbirth & labor; Chorioamnionitis; Chorioamnionitis - physiopathology; Clinical trials; Collaboration; Diagnosis; Disease prevention; Disease transmission; Double-Blind Method; Efavirenz; Evaluation; Female; Fetal Growth Retardation - etiology; Fetal Growth Retardation - pathology; Fetuses; Gestation; Gestational age; Health aspects; Health risks; HIV; HIV - isolation & purification; HIV Infections - complications; HIV Infections - epidemiology; Human immunodeficiency virus; Humans; Infant mortality; Infant, Low Birth Weight; Infant, Newborn; Infant, Small for Gestational Age; Infections; Infectious diseases; Infiltration; Inflammation; Laboratories; Leukocytes (neutrophilic); Low birth weight; Malaria; Medical diagnosis; Medical treatment; Medicine; Medicine and Health Sciences; Membranes; Morbidity; Mortality; Neonates; Neutrophils; Newborn infants; Parenchyma; Pathology; Placenta; Pregnancy; Pregnancy Complications, Infectious - etiology; Pregnant women; Premature birth; Prevalence studies (Epidemiology); Prophylaxis; Regression analysis; Risk; Small for gestational age; Tropical diseases; Uganda - epidemiology; Umbilical cord; Vector-borne diseases; Weight; Womens health; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0215058

Preterm birth (PTB) is a leading cause of neonatal mortality and longer-term morbidity. Acute chorioamnionitis (ACA) is a common cause of PTB, however, there are limited data on the prevalence of ACA and its association with PTB in resource limited settings. Data and samples came from a clinical trial evaluating novel strategies for the prevention of malaria in HIV infected pregnant women in Uganda. Women were enrolled between 12-28 weeks of gestation and followed through delivery. For each placenta delivered, three placental tissue types (membrane roll, umbilical cord and chorionic plate/villous parenchyma) were collected. Slides were assessed for diagnosis of maternal and fetal ACA by microscopic evaluation of neutrophilic infiltration using a standardized grading scale. The primary outcomes were PTB (