"Trophoblast islands of the chorionic connective tissue" (TICCT): A novel placental histologic feature

J. S. Hong; R. Romero; J. P. Kusanovic; J. S. Kim; J. Lee; M. Jin; H. El Azzamy; D. C. Lee; V. Topping; S. Ahn; S. Jacques; F. Qureshi; T. Chaiworapongsa; S. S. Hassan; S. J. Korzeniewski; N. G. Than; C. J. Kim

doi:10.1016/j.placenta.2013.01.012

"Trophoblast islands of the chorionic connective tissue" (TICCT): A novel placental histologic feature

J. S. Hong, R. Romero, J. P. Kusanovic, J. S. Kim, J. Lee, M. Jin, H. El Azzamy, D. C. Lee, V. Topping, S. Ahn, S. Jacques, F. Qureshi, T. Chaiworapongsa, S. S. Hassan, S. J. Korzeniewski, N. G. Than, C. J. Kim

Department of Obstetrics and Gynecology

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

Abstract

Introduction: We found isolated or clustered trophoblasts in the chorionic connective tissue of the extraplacental membranes, and defined this novel histologic feature as the "trophoblast islands of the chorionic connective tissue" (TICCT). This study was conducted to determine the clinical significance of TICCT. Methods: Immunohistochemistry for cytokeratin-7 was performed on the chorioamniotic membranes (N = 2155) obtained from singleton pregnancies of 1199 uncomplicated term and 956 preterm deliveries. The study groups comprised 1236 African-American and 919 Hispanic women. Gestational age ranged from 24⁺⁰ weeks to 41⁺⁶ weeks. Multiple logistic regression analysis was performed to investigate the magnitude of association between patient characteristics and the presence of TICCT. Results: The likelihood of TICCT was significantly associated with advancing gestational age both in term (OR: 1.29, 95% CI: 1.16-1.45, p < 0.001) and preterm deliveries (OR: 1.19, 95% CI: 1.07-1.32, p = 0.001). Hispanic women were less likely than African-American women to have TICCT across gestation in term (OR: 0.23, 95% CI: 0.18-0.31, p < 0.001) and preterm pregnancies (OR: 0.41, 95% CI: 0.29-0.58, p < 0.001). Women with a female fetus were significantly more likely to have TICCT than women with a male fetus, in both term (OR: 1.64, 95% CI: 1.28-2.11, p < 0.001) and preterm gestations (OR: 2.04, 95% CI: 1.46-2.85, p < 0.001). TICCT was 40% less frequent in the presence of chronic placental inflammation [term (OR: 0.60, 95% CI: 0.45-0.81, p = 0.001) and preterm gestations (OR: 0.58, 95% CI: 0.40-0.84, p = 0.003)] and in parous women at term (OR: 0.60, 95% CI: 0.44-0.81, p = 0.001). Conclusions: Our findings suggest that the duration of pregnancy, fetal sex, and parity may influence the behavior of extravillous trophoblast and placental mesenchymal cells.

Original language	English
Pages (from-to)	360-368
Number of pages	9
Journal	Placenta
Volume	34
Issue number	4
DOIs	https://doi.org/10.1016/j.placenta.2013.01.012
Publication status	Published - 2013 Apr

Bibliographical note

Funding Information:
This work was supported in part by the Perinatology Research Branch, 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. The authors are grateful to the patients who agreed to participate in our studies, the nurses, laboratory staff, and clinicians who made this work possible; and also to Maureen McGerty and Andrea Bernard (Wayne State University) for their critical readings of the manuscript.

All Science Journal Classification (ASJC) codes

Reproductive Medicine
Obstetrics and Gynaecology
Developmental Biology

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10.1016/j.placenta.2013.01.012

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Hong, J. S., Romero, R., Kusanovic, J. P., Kim, J. S., Lee, J., Jin, M., El Azzamy, H., Lee, D. C., Topping, V., Ahn, S., Jacques, S., Qureshi, F., Chaiworapongsa, T., Hassan, S. S., Korzeniewski, S. J., Than, N. G., & Kim, C. J. (2013). "Trophoblast islands of the chorionic connective tissue" (TICCT): A novel placental histologic feature. Placenta, 34(4), 360-368. https://doi.org/10.1016/j.placenta.2013.01.012

@article{0aee457127804e8985f747b074947a41,

title = "{"}Trophoblast islands of the chorionic connective tissue{"} (TICCT): A novel placental histologic feature",

abstract = "Introduction: We found isolated or clustered trophoblasts in the chorionic connective tissue of the extraplacental membranes, and defined this novel histologic feature as the {"}trophoblast islands of the chorionic connective tissue{"} (TICCT). This study was conducted to determine the clinical significance of TICCT. Methods: Immunohistochemistry for cytokeratin-7 was performed on the chorioamniotic membranes (N = 2155) obtained from singleton pregnancies of 1199 uncomplicated term and 956 preterm deliveries. The study groups comprised 1236 African-American and 919 Hispanic women. Gestational age ranged from 24+0 weeks to 41+6 weeks. Multiple logistic regression analysis was performed to investigate the magnitude of association between patient characteristics and the presence of TICCT. Results: The likelihood of TICCT was significantly associated with advancing gestational age both in term (OR: 1.29, 95% CI: 1.16-1.45, p < 0.001) and preterm deliveries (OR: 1.19, 95% CI: 1.07-1.32, p = 0.001). Hispanic women were less likely than African-American women to have TICCT across gestation in term (OR: 0.23, 95% CI: 0.18-0.31, p < 0.001) and preterm pregnancies (OR: 0.41, 95% CI: 0.29-0.58, p < 0.001). Women with a female fetus were significantly more likely to have TICCT than women with a male fetus, in both term (OR: 1.64, 95% CI: 1.28-2.11, p < 0.001) and preterm gestations (OR: 2.04, 95% CI: 1.46-2.85, p < 0.001). TICCT was 40% less frequent in the presence of chronic placental inflammation [term (OR: 0.60, 95% CI: 0.45-0.81, p = 0.001) and preterm gestations (OR: 0.58, 95% CI: 0.40-0.84, p = 0.003)] and in parous women at term (OR: 0.60, 95% CI: 0.44-0.81, p = 0.001). Conclusions: Our findings suggest that the duration of pregnancy, fetal sex, and parity may influence the behavior of extravillous trophoblast and placental mesenchymal cells.",

author = "Hong, {J. S.} and R. Romero and Kusanovic, {J. P.} and Kim, {J. S.} and J. Lee and M. Jin and {El Azzamy}, H. and Lee, {D. C.} and V. Topping and S. Ahn and S. Jacques and F. Qureshi and T. Chaiworapongsa and Hassan, {S. S.} and Korzeniewski, {S. J.} and Than, {N. G.} and Kim, {C. J.}",

note = "Funding Information: This work was supported in part by the Perinatology Research Branch, 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. The authors are grateful to the patients who agreed to participate in our studies, the nurses, laboratory staff, and clinicians who made this work possible; and also to Maureen McGerty and Andrea Bernard (Wayne State University) for their critical readings of the manuscript.",

year = "2013",

month = apr,

doi = "10.1016/j.placenta.2013.01.012",

language = "English",

volume = "34",

pages = "360--368",

journal = "Placenta",

issn = "0143-4004",

publisher = "W.B. Saunders Ltd",

number = "4",

}

Hong, JS, Romero, R, Kusanovic, JP, Kim, JS, Lee, J, Jin, M, El Azzamy, H, Lee, DC, Topping, V, Ahn, S, Jacques, S, Qureshi, F, Chaiworapongsa, T, Hassan, SS, Korzeniewski, SJ, Than, NG & Kim, CJ 2013, '"Trophoblast islands of the chorionic connective tissue" (TICCT): A novel placental histologic feature', Placenta, vol. 34, no. 4, pp. 360-368. https://doi.org/10.1016/j.placenta.2013.01.012

TY - JOUR

T1 - "Trophoblast islands of the chorionic connective tissue" (TICCT)

T2 - A novel placental histologic feature

AU - Hong, J. S.

AU - Romero, R.

AU - Kusanovic, J. P.

AU - Kim, J. S.

AU - Lee, J.

AU - Jin, M.

AU - El Azzamy, H.

AU - Lee, D. C.

AU - Topping, V.

AU - Ahn, S.

AU - Jacques, S.

AU - Qureshi, F.

AU - Chaiworapongsa, T.

AU - Hassan, S. S.

AU - Korzeniewski, S. J.

AU - Than, N. G.

AU - Kim, C. J.

N1 - Funding Information: This work was supported in part by the Perinatology Research Branch, 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. The authors are grateful to the patients who agreed to participate in our studies, the nurses, laboratory staff, and clinicians who made this work possible; and also to Maureen McGerty and Andrea Bernard (Wayne State University) for their critical readings of the manuscript.

PY - 2013/4

Y1 - 2013/4

N2 - Introduction: We found isolated or clustered trophoblasts in the chorionic connective tissue of the extraplacental membranes, and defined this novel histologic feature as the "trophoblast islands of the chorionic connective tissue" (TICCT). This study was conducted to determine the clinical significance of TICCT. Methods: Immunohistochemistry for cytokeratin-7 was performed on the chorioamniotic membranes (N = 2155) obtained from singleton pregnancies of 1199 uncomplicated term and 956 preterm deliveries. The study groups comprised 1236 African-American and 919 Hispanic women. Gestational age ranged from 24+0 weeks to 41+6 weeks. Multiple logistic regression analysis was performed to investigate the magnitude of association between patient characteristics and the presence of TICCT. Results: The likelihood of TICCT was significantly associated with advancing gestational age both in term (OR: 1.29, 95% CI: 1.16-1.45, p < 0.001) and preterm deliveries (OR: 1.19, 95% CI: 1.07-1.32, p = 0.001). Hispanic women were less likely than African-American women to have TICCT across gestation in term (OR: 0.23, 95% CI: 0.18-0.31, p < 0.001) and preterm pregnancies (OR: 0.41, 95% CI: 0.29-0.58, p < 0.001). Women with a female fetus were significantly more likely to have TICCT than women with a male fetus, in both term (OR: 1.64, 95% CI: 1.28-2.11, p < 0.001) and preterm gestations (OR: 2.04, 95% CI: 1.46-2.85, p < 0.001). TICCT was 40% less frequent in the presence of chronic placental inflammation [term (OR: 0.60, 95% CI: 0.45-0.81, p = 0.001) and preterm gestations (OR: 0.58, 95% CI: 0.40-0.84, p = 0.003)] and in parous women at term (OR: 0.60, 95% CI: 0.44-0.81, p = 0.001). Conclusions: Our findings suggest that the duration of pregnancy, fetal sex, and parity may influence the behavior of extravillous trophoblast and placental mesenchymal cells.

AB - Introduction: We found isolated or clustered trophoblasts in the chorionic connective tissue of the extraplacental membranes, and defined this novel histologic feature as the "trophoblast islands of the chorionic connective tissue" (TICCT). This study was conducted to determine the clinical significance of TICCT. Methods: Immunohistochemistry for cytokeratin-7 was performed on the chorioamniotic membranes (N = 2155) obtained from singleton pregnancies of 1199 uncomplicated term and 956 preterm deliveries. The study groups comprised 1236 African-American and 919 Hispanic women. Gestational age ranged from 24+0 weeks to 41+6 weeks. Multiple logistic regression analysis was performed to investigate the magnitude of association between patient characteristics and the presence of TICCT. Results: The likelihood of TICCT was significantly associated with advancing gestational age both in term (OR: 1.29, 95% CI: 1.16-1.45, p < 0.001) and preterm deliveries (OR: 1.19, 95% CI: 1.07-1.32, p = 0.001). Hispanic women were less likely than African-American women to have TICCT across gestation in term (OR: 0.23, 95% CI: 0.18-0.31, p < 0.001) and preterm pregnancies (OR: 0.41, 95% CI: 0.29-0.58, p < 0.001). Women with a female fetus were significantly more likely to have TICCT than women with a male fetus, in both term (OR: 1.64, 95% CI: 1.28-2.11, p < 0.001) and preterm gestations (OR: 2.04, 95% CI: 1.46-2.85, p < 0.001). TICCT was 40% less frequent in the presence of chronic placental inflammation [term (OR: 0.60, 95% CI: 0.45-0.81, p = 0.001) and preterm gestations (OR: 0.58, 95% CI: 0.40-0.84, p = 0.003)] and in parous women at term (OR: 0.60, 95% CI: 0.44-0.81, p = 0.001). Conclusions: Our findings suggest that the duration of pregnancy, fetal sex, and parity may influence the behavior of extravillous trophoblast and placental mesenchymal cells.

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"Trophoblast islands of the chorionic connective tissue" (TICCT): A novel placental histologic feature

Abstract

Bibliographical note

All Science Journal Classification (ASJC) codes

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