-Short Review-

Role of the Placenta in Adverse Perinatal Outcomes among HIV-1 Seropositive Women

William Ackerman IV¹ and Jesse J. Kwiek²

¹Laboratory of Perinatal Research, Department of Obstetrics and Gynecology, College of Medicine, The Ohio State University, USA
²The Division of Infectious Diseases, Department of Medicine, The Center for Microbial Interface Biology, and Public Health Preparedness for Infectious Diseases Program, The Ohio State University, USA

Women seropositive for human immunodeficiency virus type 1 (HIV-1) are at an increased risk for a number of adverse perinatal outcomes. Although efforts to reduce mother-to-child transmission of HIV (MTCT) remain a priority in resource-limited countries, HIV testing and treatment have led to steep declines in MTCT in well-resourced countries. Even so, HIV seropositive pregnant women in the United States continue to deliver a disproportionately high number of preterm and low birth weight infants. In this mini-review, we address the role of the placenta in such HIV-related perinatal sequelae. We posit that adverse perinatal outcomes may result from two mutually non-exclusive routes: (1) HIV infection of the placenta proper, potentially leading to impaired maternal-fetal exchange; and (2) infection of the maternal decidual microenvironment, possibly disrupting normal placental implantation and development. Further research into the relationship between HIV-1 infection and placental pathology may lead to the development of novel strategies to improve birth outcomes among HIV-1 seropositive parturients.

J Nippon Med Sch 2013; 80: 90-94

Keywords
human immunodeficiency virus type 1, placenta, placenta diseases, low birth weight, preterm birth

Correspondence to
William E. Ackerman IV, Laboratory of Perinatal Research, Department of Obstetrics and Gynecology, College of Medicine, The Ohio State University, N525 Doan Hall, 410 West 10th Avenue, Columbus, OH 43210, USA
william.ackerman@osumc.edu

Received, November 1, 2012
Accepted, February 8, 2013