SRI Supplement to Reproductive Sciences - Volume 25 Number 1 - March 2018 - 159A

Scientific Abstracts

T-149
Placental Lesions in Advanced Maternal Age Live Births and
Stillbirths. Karen J Gibbins,6 Robert M Silver,6 Halit Pinar,1 Michael W
Varner,6 Donald Dudley,7 Robert L Goldenberg,2 George R Saade,5 Radek
Bukowski,4 Uma M Reddy*.3 1Brown University, Providence, RI, United
States; 2Columbia University, New York, NY, United States; 3National
Institute of Health, Bethesda, MD, United States; 4University of Texas
at Austin - Dell Medical School, Austin, TX, United States; 5University
of Texas Medical Branch, Galveston, TX, United States; 6University of
Utah Health, Salt Lake City, UT, United States; 7University of Virginia,
Charlottesville, VA, United States.
INTRODUCTION: Advanced maternal age (AMA) (≥35 years) is
independently associated with increased risk of stillbirth. The pathway
remains uncertain, but accelerated placental "aging" resulting in placental
insufficiency has been proposed. Our objective was to evaluate placental
lesions associated with AMA in live births and stillbirths.
METHODS: The Stillbirth Collaborative Research Network (SCRN)
conducted a population-based, case-control study of stillbirths and live
births from 2006-2008. This secondary analysis includes women without
chronic disease or hypertensive disease of pregnancy who delivered
non-anomalous live births or stillbirths and had a placental pathologic
examination. Individual lesions and categories of lesions were reported
as weighted frequencies and odds ratios adjusted for race and nulliparity
(aORs). Age categories were <25 years, 25-29, 30-34, and 35+ years, with
25-29 used as the referent group. All analyses were weighted to account
for sampling design availability of complete placental examination.
RESULTS: After weighting, in live births there were 99 women of AMA
and 645 younger women. In live births, chorionic plate acute vasculitis
was the only individual lesion that varied by age group: more frequent
in the <25 year old group (aOR 3.8, 95% CI 1.3-0.8) and 35+ group
(aOR 6.6, 95% CI 2.2-20). When analyzed by lesion category, fetal
inflammatory response was more common in the 35+ group (aOR 2.7,
95% CI 1.1-6.3) (Table 1).
After weighting, in stillbirths there were 28 women of AMA and 277
younger women. In stillbirths, single umbilical artery was more common
in the 35+ group (aOR 6.4, 95% CI 1.5-28.1). There were also more
umbilical cord coils per centimeter in the 35+ group (0.4) compared to
the 25-29 group (0.2) (p=0.01). Parenchymal infarction was less common
in the 35+ group (aOR 0.2, 95% CI 0.1-0.8). When analyzed by lesion
category, there were no differences by age group in stillbirths (Table 1).
CONCLUSION: Few placental lesions are associated with AMA in live
births or stillbirths. In stillbirths, umbilical cord abnormalities are more
common in AMA women.

159A

Frequency of placental lesions by maternal age categories, stillbirths. *=aOR
not calculated
Placental Lesion Category

Umbilical cord disorders

Placental membrane
disorder*
Fetal villous capillary
abnormality

Maternal inflammatory
response

Fetal inflammatory
response

Villitis

Maternal circulatory
disorder

Fetal circulatory disorder

25-29
Years

30-34
Years

35+ Years

Nw=137.7

Nw=83.4

Nw=55.8

Nw=40.1

%

%

%

%

aOR (95% aOR
CI)
(95% CI)

aOR
(95% CI)

aOR (95%
CI)

12.6

<25 Years

9.4

9.1

26.9

1.3 (0.53.9)

Ref

0.9 (0.32.8)

3.4 (1.110.2)

1.6

4.4

0

0

--

--

--

--

9.5

9.8

5.2

17.5

0.8 (0.32.2)

Ref

0.4 (0.11.8)

2.0 (0.66.7)

41.1

37.5

40.6

44.3

1.1 (0.62.0)

Ref

1.2 (0.62.4)

1.4 (0.63.2)

20.9

21.5

25.7

23.9

0.8 (0.41.7)

Ref

1.3 (0.62.4)

1.2 (0.43.0)

1.1

2.5

1.9

6.5

0.3 (0.042.2)

Ref

0.8 (0.19.8)

3.0 (0.422.2)

53.5

50.3

59.4

45.3

1.2 (0.72.1)

Ref

1.5 (0.72.9)

0.8 (0.41.9)

30.9

31.5

30.4

41.6

Ref

0.9 (0.42.0)

1.5 (0.73.5)

0.9 (0.51.7)

T-150
Characterization of ERV-K (HML-2) Envelope Expression and
Function in the Primate Placenta. Jimi L Rosenkrantz†,1,2 Peta L
Grigsby,1,2 Lucia Carbone,1 Shawn L Chavez*.1,2 1Oregon Health &
Science University (OHSU), Portland, OR, United States; 2Oregon
National Primate Research Center (ONPRC), Beaverton, OR, United
States.
INTRODUCTION: Endogenous retroviruses (ERVs) are relics of
ancient viral attacks on the genome and account for ~8% of human DNA.
Despite initial classification as 'junk' DNA, several ERV derived proteins
are now known to play important biological roles in early mammalian
development. Recently, the envelope protein from the primate-specific
ERV-K (HML-2) group of ERVs, ERV-K-env, was shown to be highly
expressed during human placentation. Moreover, immunosuppressive
and fusion domains were identified in the predicted protein sequence of
ERV-K-env, suggesting a potential role for ERV-K-env in trophoblast cell
fusion and/or maternal immune suppression during placental development.
We hypothesized that placental ERV-K-env has been exapted by primate
genomes to play important physiological roles during normal primate
placentation, and that placental dysfunction in pregnancy complications
are associated with dysregulation of ERV-K-env expression.
METHODS: Using a combination of quantitative RT-PCR,
immunohistochemistry, and multi-color confocal imaging of
immunofluorescence, we examined ERV-K-env expression in different
primate placental samples, including normal term controls, human preterm
birth, and an ureaplasma-induced (UEI) rhesus model of preterm birth.
We also assessed ERV-K-env expression in primary rhesus trophoblast
cells isolated from either 1st or 3rd trimester placentas and immortalized
with or without human telomerase (hTERT).

Thursday Posters

CD8+ cells. Moreover, CD8+ central memory cells (CD45RO+CCR7+)
and CD8+ tissue resident cells (CD45RO+CD103+) were higher in
decidua parietalis as compared to decidua basalis. Lastly, activation status
(CD69+) was higher for all memory subsets (except for CD4+ effector
memory cells) in decidua parietalis as compared to decidua basalis.
CONCLUSION: This study shows that memory T cell subsets are
differently distributed in decidua parietalis and basalis, with higher
percentages of memory T-cell subsets as well as more activated memory
T-cell subsets found in decidua parietalis as compared to decidua basalis.
Since memory T cells are found to be present at higher percentages
in decidua parietalis, this could suggest that these cells are especially
important for creating tolerance to the fetal membranes.

Reproductive Sciences Vol. 25, Supplement 1, March 2018
Table of Contents for the Digital Edition of SRI Supplement to Reproductive Sciences - Volume 25 Number 1 - March 2018
