Fetal membranes (combined amniochorion and decidua) were collected from TNIL cesarean deliveries with no documented pregnancy complications and TL vaginal deliveries. Fetal membranes were dissected from the placenta, washed three times in normal saline, and cleansed of blood clots using cotton gauze. Six-millimeter biopsies (explants) was then cut from the midzone portion of the membranes, avoiding the regions overlying the cervix or placenta. The amnion was then separated from the chorion, and explants were processed for a variety of assays.

Inclusion criteria are as follows: Normal term births were women with TL and delivery (>390/7 weeks) and no pregnancy-related complications. Exclusion criteria are as follows: Subjects with multiple gestations, placenta previa, fetal anomalies, and/or medical or surgeries (intervention for clinical conditions that are not linked to pregnancy) during pregnancy were excluded. Severe cases of preeclampsia or persistent symptoms (headache, vision changes, and right upper quadrant pain) or abnormal laboratory findings [thrombocytopenia, repeated abnormal liver function tests, creatinine doubling or greater than 1.2, or hemolysis, elevated liver enzymes, and a low platelet count (HELLP) syndrome] or clinical findings (pulmonary edema or eclampsia) were excluded. Subjects who had any surgical procedures during pregnancy or who were treated for hypertension, preterm labor, or suspected clinical chorioamnionitis (reports on foul-smelling vaginal discharge, high levels of complement-reactive protein, and fetal tachycardia); who had positive group B streptococcus screening or diagnosis of bacterial vaginosis, behavioral issues (cigarette smoking and drug or alcohol abuse); and who delivered at term were excluded from the control groups.

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