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Am J Perinatol 2017; 34(10): 1003-1010
DOI: 10.1055/s-0037-1601353
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA

Maternal Income during Pregnancy is Associated with Chronic Placental Inflammation at Birth

Lauren S. Keenan-Devlin
1   Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Evanston, Illinois
,
Linda M. Ernst
2   Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
,
Kharah M. Ross
3   Department of Psychology and Institute for Policy Research, Northwestern University, Evanston, Illinois
,
Sameen Qadir
1   Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Evanston, Illinois
,
William A. Grobman
4   Division of Maternal-Fetal Medicine and Center for Healthcare Studies, Department of Obstetrics and Gynecology, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
,
Jane L. Holl
5   Department of Pediatrics, Northwestern University Feinberg School of Medicine, Center for Healthcare Studies—Institute for Public Health and Medicine, Greenville, South Carolina
,
Amy Crockett
6   Department of Obstetrics and Gynecology, Greenville Hospital System University Medical Center, Greenville, South Carolina
,
Gregory E. Miller
3   Department of Psychology and Institute for Policy Research, Northwestern University, Evanston, Illinois
,
Ann E. B. Borders
7   Department of Obstetrics and Gynecology, NorthShore University HealthSystem, University of Chicago Pritzker School of Medicine; Northwestern University Center for Healthcare Studies—Institute for Public Health and Medicine, Evanston, Illinois
› Author Affiliations
Further Information

Publication History

15 November 2016

17 February 2017

Publication Date:
06 April 2017 (online)

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Abstract

Objective This study aims to examine whether maternal household income is associated with histological evidence of chronic placental inflammation.

Study Design A total of 152 participants completed surveys of household income and consented to placenta collection at delivery and postpartum chart review for birth outcomes. Placental inflammatory lesions were evaluated via histological examination of the membranes, basal plate, and villous parenchyma by a single, experienced pathologist. Associations between household income and the presence of inflammatory lesions were adjusted for known perinatal risk factors.

Results Overall, 45% of participants reporting household income below $30,000/y had chronic placental inflammation, compared with 25% of participants reporting income above $100,000 annually (odds ratio [OR] = 4.23, 95% confidence interval [CI] = 1.25, 14.28; p = 0.02). Middle-income groups showed intermediate rates of chronic inflammatory lesions, at 40% for those reporting $30,000 and 50,000 (OR = 3.60, 95% CI = 1.05, 12.53; p = 0.04) and 38% for those reporting $50,000 to 100,000 (OR = 1.57, 95% CI = 0.60, 4.14; p = 0.36). Results remained significant after adjustment for maternal age, race, and marital status.

Conclusion Chronic placental inflammation is associated with maternal household income. Greater occurrence of placental lesions in low-income mothers may arise from a systemic inflammatory response to social and physical environmental factors.

Keywords

chronic inflammation - chronic deciduitis - chronic villitis - income - placenta - pregnancy - stress
 

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