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

• Published in: Placenta (Eastbourne) Vol. 34; no. 4; pp. 360 - 368
• Main Authors: 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
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.04.2013; Elsevier
• Subjects: Biological and medical sciences; Black or African American; Chile; Chorioamniotic membranes; Chorion - pathology; Cytokeratin-7; Embryology: invertebrates and vertebrates. Teratology; Female; Fetal sex; Fundamental and applied biological sciences. Psychology; Hispanic or Latino; Humans; Infant, Newborn; Infant, Premature; Internal Medicine; Keratin-7 - analysis; Male; Michigan; Obstetrics and Gynecology; Parity; Placenta - pathology; Placenta Diseases - pathology; Pregnancy; Premature Birth - pathology; Sex Factors; Trophoblasts - pathology; White People; Chile; Michigan; Pregnancy; Chorioamniotic membranes; Cytokeratin-7; Fetal sex; Trophoblaste; Connective tissue; Vertebrata; Mammalia; Placenta; Fetal membrane; Chorion
• ISSN: 0143-4004; 1532-3102
• DOI: 10.1016/j.placenta.2013.01.012

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.