Table 1.
Demographic, Medical, and Placental Characteristics in a Cohort of Women Presenting in Labor to Mbarara Regional Referral Hospital, Uganda, by Vascular Endothelial Growth Factor A Staining
| Characteristic | Women (or Newborns), No. (%)a | P Valueb | |
|---|---|---|---|
| VEGF-A Staining (n = 41 [12%]) | No Staining (n = 311 [88%]) | ||
| Demographic | |||
| Age category. y | .29 | ||
| ≤19 | 3 (7) | 26 (8) | |
| 20–34 | 29 (70) | 245 (79) | |
| ≥35 | 9 (22) | 40 (13) | |
| Resides in Mbarara District | 24 (59) | 203 (65) | .40 |
| Married | 35 (85) | 282 (91) | .29 |
| Completed more than primary school education | 24 (59) | 183 (59) | .97 |
| Monthly income, median (IQR), $ c | 25 (14–53) | 42 (28–83) | .04 |
| Formal employment outside home | 15 (37) | 112 (36) | .94 |
| Obstetric and medical | |||
| HIV seropositive | 27 (66) | 149 (48) | .03 |
| Gestational age at delivery, mean (SD), wk | 38 (2.6) | 39 (1.7) | <.001 |
| Preterm delivery (<37 wk) | 2 (5) | 3 (1) | .1 |
| Parity including current delivery | .49 | ||
| 1 (Primiparous) | 10 (24) | 77 (25) | |
| 2–4 (Multiparous) | 21 (51) | 132 (42) | |
| ≥4 (Grand multiparous) | 10 (24) | 102 (33) | |
| Antenatal care during current pregnancy | |||
| ≥4 antenatal care visits | 25 (61) | 198 (64) | .74 |
| Iron supplementation | 29 (71) | 184 (59) | .15 |
| Folic acid supplementation | 14 (34) | 137 (44) | .23 |
| Combination iron/folic acid | 32 (78) | 210 (68) | .17 |
| Malaria prophylaxis with IPTp or TMP/SMXd | 39 (95) | 297 (96) | .91 |
| Time in labor, median (IQR), h | 12 (9, 18) | 14 (8, 24) | .33 |
| Cesarean delivery | 13 (32) | 101 (32) | .92 |
| Referred to MRRH for care | 7 (17) | 49 (16) | .84 |
| 5-min Apgar score <7 | 0 (0) | 8 (3) | .32 |
| Duration of hospitalization for delivery, mean (SD), d | 2.2 (2) | 2.2 (3) | .99 |
| Birthweight category, kg | .003 | ||
| <2.5 | 6 (15) | 10 (3) | |
| 2.5–3.5 | 32 (78) | 233 (76) | |
| 3.6–4.0 | 2 (5) | 57 (19) | |
| >4.0 | 1 (2) | 8 (3) | |
| Pathology | |||
| Placental measurements, mean (SD) | |||
| Trimmed placental weight in grams (mean, SD) | 394 (116) | 466 (96) | <.001 |
| Greatest placental diameter, cm | 19 (2) | 20 (2) | <.001 |
| Greatest placental thickness, cm | 1.6 (0.5) | 1.7 (0.6) | .90 |
| Umbilical cord length, cm | 41 (14) | 40 (17) | .72 |
| Cord coiling indexe | 0.16 (0.08) | 0.18 (0.07) | .04 |
| Histologic abruption | 0 (0) | 1 (0.3) | 1.0 |
| Placental infarct(s) | 13 (32) | 0 (0) | <.001 |
| Diffuse distal villous hypoplasia | 3 (7) | 0 (0) | .001 |
| Decidual arteriopathy | 0 (0) | 1 (0.3) | .89 |
| Fetal vascular malperfusion | 4 (13) | 37 (11) | .76 |
| Maternal vascular malperfusion | 20 (51) | 23 (8) | <.001 |
| Chronic villitis | 2 (7) | 39 (12) | .48 |
| Villitis of unknown cause | 2 (8) | 24 (8) | .51 |
| Acute chorioamnionitis | 7 (17) | 92 (30) | .09 |
Abbreviations: HIV, human immunodeficiency virus; IPTp, intermittent preventive treatment in pregnancy; IQR, interquartile range; MRRH, Mbarara Regional Referral Hospital; SD, standard deviation; TMP/SMX, trimethoprim-sulfamethoxazole; VEGF-A, vascular endothelial growth factor A.
aData represent no. (%) of women (or infants) unless otherwise specified. Of 352 participants, 44 (13%) had placentas were selected for VEGF-A immunostaining based on having ≥1 of the following features of or risk factors for maternal vascular malperfusion: placental weight below the fifth percentile, placental infarct, receipt of nevirapine for HIV treatment, preeclampsia or eclampsia during the current pregnancy, placental histology showing diffuse distal villous hypoplasia, and hypertension during the current pregnancy; 2 of 44 met >1 selection criterion.
bTests of association between cohort characteristics and HIV serostatus were performed using χ 2, Wilcoxon rank sum, and t tests.
cReported by participant in Ugandan shillings, converted to US dollars using exchange rate for study start date (1 March 2017: $1 = 3600 Ugandan shillings);
dIPTp with either sulfadoxine-pyrimethamine or dihydroartemisinin-piperaquine, or routine prophylaxis with TMP/SMX in participants living with HIV.
eThe cord coiling index was calculated as the number of coils divided by the umbilical cord length in centimeters.