ArticleAnnals of epidemiology2023
Prepregnancy obesity and risk of placental inflammation at term: a selection bias analysis.
Article in Annals of epidemiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed.
- Molecular Mechanisms of Obesity-Associated Oxidative Stress and Therapeutic Strategies.Antioxidants (Basel, Switzerland) · 2026Review
- Placental histopathology and early childhood neurodevelopment in the Environmental influences on Child Health Outcomes cohort.American journal of obstetrics and gynecology · 2026Article
- Developmental origins of immunometabolic health.Immunometabolism (Cobham, Surrey) · 2026Review
- Investigating and quantifying selection bias in research using placental pathology samples.Pregnancy (Hoboken, N.J.) · 2025Article
- Pregnancy-Associated Plasma Protein-A and Free β-Human Chorionic Gonadotrophin in Relation with Oxidative Stress in Obese Pregnant Women: A Clinical Cross-Sectional Study.Pathophysiology : the official journal of the International Society for Pathophysiology · 2024Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
purposePlacental histopathology is a resource for investigating obesity-associated pregnancy conditions. However, studies oversample adverse pregnancies, biasing findings. We examine the association between prepregnancy obesity (risk factor for inflammation) and histologic placental inflammation (correlated with impaired infant neurodevelopment) and how selection bias may influence the association.
methodsSingleton term deliveries between 2008 and 2012 from the Magee Obstetric Maternal and Infant database were analyzed. Prepregnancy body mass index (BMI) was categorized as underweight, lean (referent), overweight, and obese. Outcomes were diagnoses of acute (acute chorioamnionitis and fetal inflammation) and chronic placental inflammation (chronic villitis). Risk ratios for associations between BMI and placental inflammation were estimated using selection bias approaches: complete case, exclusion of pregnancy complications, multiple imputation, and inverse probability weighting. E-values approximated how susceptible estimates were to residual selection bias.
resultsAcross methods, obesity was associated with an 8-15% lower risk of acute chorioamnionitis, a 7%-14% lower risk of acute fetal inflammation, and a 12%-30% higher risk of chronic villitis relative to lean women. E-values indicated modest residual selection bias could explain away associations, though few measured indications of placental evaluations met this threshold.
conclusionsObesity may contribute to placental inflammation, and we highlight robust methods to analyze clinical data susceptible to selection bias.
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